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Long-term outcomes after hepatic resection for colorectal metastases in young patients
Article first published online: 8 DEC 2009
Copyright © 2009 American Cancer Society
Volume 116, Issue 3, pages 647–658, 1 February 2010
How to Cite
de Haas, R. J., Wicherts, D. A., Salloum, C., Andreani, P., Sotirov, D., Adam, R., Castaing, D. and Azoulay, D. (2010), Long-term outcomes after hepatic resection for colorectal metastases in young patients. Cancer, 116: 647–658. doi: 10.1002/cncr.24721
- Issue published online: 25 JAN 2010
- Article first published online: 8 DEC 2009
- Manuscript Accepted: 20 APR 2009
- Manuscript Revised: 18 APR 2009
- Manuscript Received: 18 FEB 2009
- colorectal neoplasms;
- liver neoplasms;
- young patients
Long-term outcomes after hepatectomy for colorectal liver metastases in relatively young patients are still unknown. The aim of the current study was to evaluate long-term outcomes in patients ≤40 years old, and to compare them with patients >40 years old.
All consecutive patients who underwent hepatectomy for colorectal liver metastases at the authors' hospital between 1990 and 2006 were included in the study. Patients ≤40 years old were compared with all other patients treated during the same period. Overall survival (OS), progression-free survival (PFS), and disease-free survival (DFS) rates were determined, and prognostic factors were identified.
In total, 806 patients underwent hepatectomy for colorectal liver metastases, of whom 56 (7%) were aged ≤40 years. Among the young patients, more colorectal liver metastases were present at diagnosis, and they were more often diagnosed synchronous with the primary tumor. Five-year OS was 33% in young patients, compared with 51% in older patients (P = .12). Five-year PFS was 2% in young patients, compared with 16% in older patients (P < .001). DFS rates were comparable between the groups (17% vs 23%, P = .10). At multivariate analysis, age ≤40 years was identified as an independent predictor of poor PFS.
In young patients, colorectal liver metastases seem to be more aggressive, with a trend toward lower OS, more disease recurrences, and a significantly shorter PFS after hepatectomy. However, DFS rates were comparable between young and older patients, owing to an aggressive multimodality treatment approach, consisting of chemotherapy and repeat surgery. Therefore, physicians should recognize the poor outcome of colorectal liver metastases in young patients and should consider an aggressive approach to diagnosis and early treatment. Cancer 2010. © 2009 American Cancer Society.