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High resection rates of colorectal liver metastases after standardized follow-up and multimodal management : an outcome study within the COLOFOL trial

Scherman, Peter LU ; Hansdotter, Pernilla LU ; Holmberg, Erik ; Viborg Mortensen, Frank ; Petersen, Sune H. ; Rizell, Magnus ; Naredi, Peter LU and Syk, Ingvar LU (2023) In HPB 25(7). p.766-774
Abstract

Background: Outcome after colorectal liver metastases (CRLM) resection has improved over time, despite increased resection rates. Hence, it's crucial to identify all patients possible to treat with curative intent. The objectives of this study were to map recurrence pattern, treatment strategy and survival depending on treatment and follow-up strategy. Methods: In the COLOFOL-trial, patients with radically resected stage II-III colorectal cancer were randomized to high-frequency (6, 12, 18, 24 and 36 months; HF) or low-frequency (12 and 36 months; LF) follow-up. In this study, all CRLM within 5 years were identified and medical files scrutinized. Overall survival (OS) was analysed in uni- and multivariable analyses. Primary endpoint was... (More)

Background: Outcome after colorectal liver metastases (CRLM) resection has improved over time, despite increased resection rates. Hence, it's crucial to identify all patients possible to treat with curative intent. The objectives of this study were to map recurrence pattern, treatment strategy and survival depending on treatment and follow-up strategy. Methods: In the COLOFOL-trial, patients with radically resected stage II-III colorectal cancer were randomized to high-frequency (6, 12, 18, 24 and 36 months; HF) or low-frequency (12 and 36 months; LF) follow-up. In this study, all CRLM within 5 years were identified and medical files scrutinized. Overall survival (OS) was analysed in uni- and multivariable analyses. Primary endpoint was 5-year OS. Results: Of 2442 patients, 235 (9.6%) developed metachronous CRLM of which 123 (52.3%) underwent treatment with curative intent, resulting in 5-year OS of 58%. Five-year OS for patients with CRLM was 43% after HF versus 24% after LF. The survival benefit was confirmed for HF 8 years from resection of the primary tumour, HR 0.63 (CI 0.46–0.85). Conclusion: A high proportion of metachronous CRLM was possible to treat with curative intent, yielding high survival rates. More intense follow-up after colorectal cancer resection might be of value in high-risk patients.

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author collaboration
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
HPB
volume
25
issue
7
pages
766 - 774
publisher
Elsevier
external identifiers
  • pmid:36967324
  • scopus:85150836501
ISSN
1365-182X
DOI
10.1016/j.hpb.2023.03.003
language
English
LU publication?
yes
id
4c2a79fe-06a7-4135-9756-1ca1e71ac1d2
date added to LUP
2023-05-26 14:17:49
date last changed
2024-07-13 05:50:09
@article{4c2a79fe-06a7-4135-9756-1ca1e71ac1d2,
  abstract     = {{<p>Background: Outcome after colorectal liver metastases (CRLM) resection has improved over time, despite increased resection rates. Hence, it's crucial to identify all patients possible to treat with curative intent. The objectives of this study were to map recurrence pattern, treatment strategy and survival depending on treatment and follow-up strategy. Methods: In the COLOFOL-trial, patients with radically resected stage II-III colorectal cancer were randomized to high-frequency (6, 12, 18, 24 and 36 months; HF) or low-frequency (12 and 36 months; LF) follow-up. In this study, all CRLM within 5 years were identified and medical files scrutinized. Overall survival (OS) was analysed in uni- and multivariable analyses. Primary endpoint was 5-year OS. Results: Of 2442 patients, 235 (9.6%) developed metachronous CRLM of which 123 (52.3%) underwent treatment with curative intent, resulting in 5-year OS of 58%. Five-year OS for patients with CRLM was 43% after HF versus 24% after LF. The survival benefit was confirmed for HF 8 years from resection of the primary tumour, HR 0.63 (CI 0.46–0.85). Conclusion: A high proportion of metachronous CRLM was possible to treat with curative intent, yielding high survival rates. More intense follow-up after colorectal cancer resection might be of value in high-risk patients.</p>}},
  author       = {{Scherman, Peter and Hansdotter, Pernilla and Holmberg, Erik and Viborg Mortensen, Frank and Petersen, Sune H. and Rizell, Magnus and Naredi, Peter and Syk, Ingvar}},
  issn         = {{1365-182X}},
  language     = {{eng}},
  number       = {{7}},
  pages        = {{766--774}},
  publisher    = {{Elsevier}},
  series       = {{HPB}},
  title        = {{High resection rates of colorectal liver metastases after standardized follow-up and multimodal management : an outcome study within the COLOFOL trial}},
  url          = {{http://dx.doi.org/10.1016/j.hpb.2023.03.003}},
  doi          = {{10.1016/j.hpb.2023.03.003}},
  volume       = {{25}},
  year         = {{2023}},
}