Table 5.
Demographic, Clinicopathologic, Operative and Outcomes Characteristics of Patients with Resectable Metachronous Colorectal Liver Metastases Stratified by Use of Adjuvant Chemotherapy
| Variable | No adjuvant chemotherapy |
Adjuvant chemotherapy |
p Value |
|---|---|---|---|
| n=457 (%) | 139(30.4) | 318(69.6) | |
| Sex | |||
| Female | 61(44.0) | 117(37) | 0.15 |
| Male | 78(56.0) | 201(63) | |
| Age, y | 66.8+/−11.6 | 62.3+/−11.3 | <0.0001 |
| BMI, kg/m2 | 28.1+/−6.0 | 28.3+/−5.1 | 0.79 |
| Year of surgery | |||
| 2000-05 | 54(38.8) | 174(54.7) | 0.002 |
| 2006-10 | 85(61.2) | 144(45.3) | |
| Hospital site | <0.0001 | ||
| 1 | 50(36.0) | 212(66.7) | |
| 2 | 34(24.5) | 35(11.0) | |
| 3 | 47(33.8) | 60(18.9) | |
| 4 | 8(5.8) | 11(3.5) | |
| Country | <0.0001 | ||
| USA | 97(69.8) | 272(85.5) | |
| Canada | 42(30.2) | 46(14.5) | |
| Type of initial referral | 0.23 | ||
| Medical | 14(10.1) | 45(14.2) | |
| Surgical | 125(89.9) | 273(85.8) | |
| Type of procedure | 0.64 | ||
| Wedge | 10(7.2) | 15(4.7) | |
| Right hepatectomy | 43(30.9) | 84(26.4) | |
| Left hepatectomy | 13(9.4) | 35(11.0) | |
| Extended right hepatectomy |
8(5.8) | 30(9.4) | |
| Extended left hepatectomy |
4(2.9) | 11(3.5) | |
| Central hepatectomy | 4(2.9) | 6(1.9) | |
| Anatomic Segmentectomy (including left lateral) |
57(41.0) | 137(43.1) | |
| Preoperative PVE | 5(3.6) | 12(3.8) | 0.98 |
| HAI | |||
| No | - | 224(70.4) | - |
| Yes | - | 91(28.6) | |
| 30-d Mortality | 1(0.7) | 0(0) | 0.12 |
| 30-d Complication | 50(36.0) | 83(26.1) | 0.03 |
| Major complication | 21(15.1) | 36(11.3) | 0.26 |
| Lymph node + primary | 72(51.8) | 140(44.0) | 0.003 |
| Preoperative CEA, ng/mL | 0.44 | ||
| ≤200 | 112(80.6) | 275(86.5) | |
| >200 | 2(1.4) | 9(2.8) | |
| Diameter of largest metastases, cm |
0.93 | ||
| ≤5 | 102(73.4) | 234(73.6) | |
| > 5 | 35(25.2) | 82(25.8) | |
| No. of tumors | 0.15 | ||
| 1 | 79(56.8) | 202(63.5) | |
| >1 | 60(43.2) | 114(35.8) | |
| Disease-free interval, mo | 0.99 | ||
| <12 | 23(16.5) | 53(16.7) | |
| ≥12 | 114(82.0) | 262(82.4) | |
| Clinical risk score | 0.07 | ||
| 0 | 23(16.5) | 52(16.4) | |
| 1 | 53(38.1) | 157(49.4) | |
| 2 | 48(34.5) | 73(23.0) | |
| 3 | 11(7.9) | 32(10.1) | |
| 4 | 2(1.4) | 2(0.6) | |
| 5 | - | - | |
| Clinical risk score dichotomized |
0.68 | ||
| Low risk (CRS 0-2) | 124(89.2) | 284(88.7) | |
| High risk (CRS 3-5) | 13(9.4) | 34(10.7) | |
| Margin status | 0.06 | ||
| Positive | 9(6.5) | 39(12.3) | |
| Negative | 130(93.5) | 278(87.4) | |
| Recurrence | 0.06 | ||
| Yes | 59(42.4) | 166(52.2) | |
| No | 80(57.6) | 152(47.8) | |
| Site of first recurrence | 0.73 | ||
| Lung | 27(19.4) | 71(22.3) | |
| Nodal | 3(2.2) | 13(4.1) | |
| Liver | 18(12.9) | 52(16.4) | |
| Local/Pelvic | 2(1.4) | 10(3.1) | |
| Peritoneal | 5(3.6) | 10(3.1) | |
| Anastomotic | 2(1.4) | 1(0.3) | |
| Adrenal | 0(0) | 1(0.3) | |
| Other | 3(2.2) | 7(2.2) | |
| Status at last follow-up | 0.59 | ||
| NED | 82(59.0) | 172(54.1) | |
| AWD | 50(36.0) | 129(40.6) | |
| DOD | 6(4.3) | 16(5.0) | |
| Survival status | 0.60 | ||
| Dead | 64(46.0) | 180(56.6) | |
| Alive | 75(54.0) | 138(43.4) | |
| LOS, d | 8.3+/−6.7 | 8.0+/−6.4 | 0.72 |
| Time from Dx-Rf, mo | 0.72+/−1.4 | 0.55+/−1.30 | 0.23 |
| Time from Rf-Rx, mo | 0.78+/−1.10 | 0.63+/−0.96 | 0.14 |
| Time from Dx-Rx, mo | 2.18+/−2.68 | 1.58+/−1.71 | 0.005 |
| Procedure time, per 30 min | 6.9+/−2.3 | 7.6+/−2.7 | 0.007 |
| Pringle time, min | 33.1+/−13.9 | 34.9+/−14.0 | 0.44 |
| EBL, per 100mL | 6.2+/−6.7 | 5.2+/−4.8 | 0.08 |
| Follow-up time from surgery, mo |
24(0-150) | 49(0-163) | <0.0001 |
Percentages for individual variables are tabulated based on total number of patients in each group (n=139, no adjuvant chemotherapy group and n=318, adjuvant chemotherapy). Categorical data are presented as frequency (%), continuous data as mean +/− standard deviation and follow-up time median (min-max). P<0.05 was considered significant.
BMI, basal metabolic index; PVE, portal vein embolization; EBL, estimated blood loss; CEA, carcinoembryonic antigen; HAI, hepatic artery infusion; NED, no evidence of disease; AWD, alive with disease; DOD, dead of disease; LOS, length of stay; Dx-Rf, diagnosis to referral; Rf-Rx, referral to resection; Dx-Rx, diagnosis to resection.