• Katsunori Imai, Castro Benitez Carlos C Centre Hépato-Biliaire, AP-HP, Hôpital Universitaire Paul Brousse, Villejuif, France. , Marc-Antoine Allard, Eric Vibert, Sa Cunha Antonio A Centre Hépato-Biliaire, AP-HP, Hôpital Universitaire Paul Brousse, Villejuif, France. , Daniel Cherqui, Denis Castaing, Henri Bismuth, Hideo Baba, and René Adam.
• Centre Hépato-Biliaire, AP-HP, Hôpital Universitaire Paul Brousse, Villejuif, France.
• J Surg Oncol. 2017 Mar 1; 115 (4): 488-496.

Background And ObjectivesWe aimed to define the cure rate in patients with colorectal liver metastases (CRLM) and concomitant extrahepatic disease (EHD) on the 5-year disease-free survival (DFS) after surgery, and identify the factors for predicting a cure.MethodsPatients who underwent hepatectomy for CRLM with concomitant EHD were identified. Those followed for >5 years after surgery were enrolled. A cure was defined as DFS of >5 years after the last curative surgery.ResultsA cure was achieved in 24/175 (13%) patients (intention-to-treat [ITT] cohort), and 22/109 (19%) patients who underwent complete resection for both hepatic and extrahepatic metastases (EHD resection cohort). A multivariate analysis identified primary T1-2 (relative risk [RR] 47.4, P = 0.0001), metachronous metastasis (RR 4.9, P = 0.026), carbohydrate antigen 19-9 (CA19-9) ≤37 U/mL (RR 8.37, P = 0.015), number of liver and EHD tumors (RR 11.2, P = 0.0058), and non-incidental EHD diagnosis (RR 8.41, P = 0.018) as independent factors that predicted a cure in the ITT cohort; and primary T1-2 (RR 22.2, P = 0.013), primary N0 (RR 4.42, P = 0.031), metachronous metastasis (RR 6.48, P = 0.013), and CA19-9 ≤37 U/mL (RR 27.4, P = 0.012) in the EHD resection cohort.ConclusionsEven when concomitant EHD is present, a potential of cure could be achieved with aggressive oncosurgical approach.© 2017 Wiley Periodicals, Inc.

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