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Background <p>This study investigated the prognostic factors of recurrent colorectal liver metastasis (r-CRLM) and the indications for repeat liver resection (RLR).</p> Methods <p>In total, 485 patients underwent initial liver resection (ILR) for CRLM. Among them, 98 with resectable r-CRLM were included in this study. Recurrence-free interval (RFI) was defined as the time between ILR and r-CRLM diagnosis. Long-term outcomes were assessed using overall survival (OS) and time to surgical failure (TSF) as endpoints.</p> Results <p>Eighty-two patients underwent RLR, and 16 received chemotherapy alone. RLR (<i>P</i> = 0.019, hazard ratio [HR] 0.37) was an independent better prognostic factor for OS in 98 patients. In 82 patients who underwent RLR, the presence of ≥ 3 tumors (<i>P</i> = 0.011, HR 2.28), tumor size ≥ 20&#xa0;mm (<i>P</i> = 0.004, HR 2.41), and RFI &lt; 180&#xa0;days (<i>P</i> = 0.006, HR 2.28) were independent prognostic factors for TSF. A score of 1 for each factor could stratify the prognosis of patients who underwent RLR (score 0 group: reference, score 1 group: HR—3.20, and score 2–3 group: HR—6.69). Patients who underwent RLR with scores of 2–3 and those who received chemotherapy alone did not significantly differ in prognosis (<i>P</i> = 0.173).</p> Conclusions <p>RFI &lt; 180&#xa0;days, presence of ≥ 3 tumors, and tumor size ≥ 20&#xa0;mm have a prognostic impact on patients with resectable r-CRLM. The RLR indications should be cautiously considered in patients with these risk factors.</p>

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Prognostic stratification of recurrent colorectal liver metastasis: impact of recurrence-free interval, tumor numbers, and size on repeat liver resection

  • 期刊论文

  • 发表日期：

    2025年11月21日

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  • Hajime Kamiya,
  • Shin Kobayashi,
  • Masashi Kudo,
  • Motokazu Sugimoto,
  • Akihito Kawazoe,
  • Hideaki Bando,
  • Yuichiro Tsukada,
  • Masaaki Ito,
  • Takayuki Yoshino,
  • Naoto Gotohda

摘要

Background

This study investigated the prognostic factors of recurrent colorectal liver metastasis (r-CRLM) and the indications for repeat liver resection (RLR).

Methods

In total, 485 patients underwent initial liver resection (ILR) for CRLM. Among them, 98 with resectable r-CRLM were included in this study. Recurrence-free interval (RFI) was defined as the time between ILR and r-CRLM diagnosis. Long-term outcomes were assessed using overall survival (OS) and time to surgical failure (TSF) as endpoints.

Results

Eighty-two patients underwent RLR, and 16 received chemotherapy alone. RLR (P = 0.019, hazard ratio [HR] 0.37) was an independent better prognostic factor for OS in 98 patients. In 82 patients who underwent RLR, the presence of ≥ 3 tumors (P = 0.011, HR 2.28), tumor size ≥ 20 mm (P = 0.004, HR 2.41), and RFI < 180 days (P = 0.006, HR 2.28) were independent prognostic factors for TSF. A score of 1 for each factor could stratify the prognosis of patients who underwent RLR (score 0 group: reference, score 1 group: HR—3.20, and score 2–3 group: HR—6.69). Patients who underwent RLR with scores of 2–3 and those who received chemotherapy alone did not significantly differ in prognosis (P = 0.173).

Conclusions

RFI < 180 days, presence of ≥ 3 tumors, and tumor size ≥ 20 mm have a prognostic impact on patients with resectable r-CRLM. The RLR indications should be cautiously considered in patients with these risk factors.