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Background <p>We aimed to characterize the outcomes of patients undergoing resection of solitary colorectal liver metastases (CLM), including patterns of recurrence and usage of salvage therapy.</p> Methods <p>A retrospective analysis of 535 consecutive patients who underwent resection of&#xa0;solitary&#xa0;CLM&#xa0;between 1999 and 2021 was performed from an institutional database. Extrahepatic disease and prior liver-directed therapy were excluded. Salvage therapy consisted of repeat resection, ablation, or radiation of all sites of recurrence. Outcomes, overall survival (OS), recurrence-free survival, and hepatic recurrence-free survival were analyzed using time-to-event methods.</p> Results <p>The median OS of the whole cohort was 10 years. At a median follow-up of 8.6 years, 52% had recurred at 3 years, 73% of which were at a single site. Salvage therapy was performed in 51% of recurrences and associated with prolonged OS (5.89 [95% confidence interval (CI) 4.68–6.64] years vs. 2.24 [95% CI 1.92–2.41] years; <i>p</i>&lt;0.001). Of those who received salvage therapy, 58% were alive 5 years after recurrence. On multivariate analysis, worse OS was associated with more than three positive lymph nodes in the colon primary (hazard ratio [HR] 2.19 [95% CI 1.56–3.08], <i>p</i>&lt;0.001), tumor size (HR 1.07 [95% CI 1.04–1.1]; <i>p</i>&lt;0.001), and positive margins (HR 1.90 [95% CI 1.07–3.37]; <i>p</i>=0.028). Use of adjuvant hepatic artery infusion chemotherapy was associated with improved OS (HR 0.74 [95% CI 0.54–0.99]; <i>p</i>=0.043) and reduced liver recurrence (HR 0.53 [95% CI 0.37–0.76]; <i>p</i>&lt;0.001).</p> Conclusions <p>Patients with resected&#xa0;solitary&#xa0;CLM&#xa0;have excellent long-term survival, with half remaining free of recurrence after initial surgery. In the event of recurrence, repeat salvage treatment is feasible and associated with improved survival.</p>

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Long-term Outcomes After Resection of Solitary Colorectal Liver Metastases

  • 期刊论文

  • 发表日期：

    2026年6月26日

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  • Mengyuan Liu,
  • Kenneth Seier,
  • Mithat Gonen,
  • Alice C. Wei,
  • Jeffrey Drebin,
  • Vinod Balachandran,
  • T. Peter Kingham,
  • Kevin Soares,
  • William R. Jarnagin,
  • Michael D’Angelica

摘要

Background

We aimed to characterize the outcomes of patients undergoing resection of solitary colorectal liver metastases (CLM), including patterns of recurrence and usage of salvage therapy.

Methods

A retrospective analysis of 535 consecutive patients who underwent resection of solitary CLM between 1999 and 2021 was performed from an institutional database. Extrahepatic disease and prior liver-directed therapy were excluded. Salvage therapy consisted of repeat resection, ablation, or radiation of all sites of recurrence. Outcomes, overall survival (OS), recurrence-free survival, and hepatic recurrence-free survival were analyzed using time-to-event methods.

Results

The median OS of the whole cohort was 10 years. At a median follow-up of 8.6 years, 52% had recurred at 3 years, 73% of which were at a single site. Salvage therapy was performed in 51% of recurrences and associated with prolonged OS (5.89 [95% confidence interval (CI) 4.68–6.64] years vs. 2.24 [95% CI 1.92–2.41] years; p<0.001). Of those who received salvage therapy, 58% were alive 5 years after recurrence. On multivariate analysis, worse OS was associated with more than three positive lymph nodes in the colon primary (hazard ratio [HR] 2.19 [95% CI 1.56–3.08], p<0.001), tumor size (HR 1.07 [95% CI 1.04–1.1]; p<0.001), and positive margins (HR 1.90 [95% CI 1.07–3.37]; p=0.028). Use of adjuvant hepatic artery infusion chemotherapy was associated with improved OS (HR 0.74 [95% CI 0.54–0.99]; p=0.043) and reduced liver recurrence (HR 0.53 [95% CI 0.37–0.76]; p<0.001).

Conclusions

Patients with resected solitary CLM have excellent long-term survival, with half remaining free of recurrence after initial surgery. In the event of recurrence, repeat salvage treatment is feasible and associated with improved survival.