Detailed Abstract
[E-poster - Liver (Liver Disease/Surgery)]
[EP 031] Analysis of Risk Factors for Recurrence And Prognostic Improvement after Liver Resection in CRLM: a Retrospective Study of 203 Cases at a Single Institution
Takamune YAMAGUCHI 1, Takayuki SHIRAKI 1, Maiko NIKI 1, Shun SATOU 1, Genki TANAKA 1, Kyung Hwa PARK 1, Takatsugu MATSUMOTO 1, Shozo MORI 1, Yukihiro ISO 1, Taku AOKI 1
1 Department of Hepato-biliary And Pancreatic Surgery, Dokkyo Medical University, JAPAN
Background : A clear definition of resectable/borderline Colorectal Liver Metastases (CRLM) and treatment strategies have not been established.
Methods : This retrospective study analyzed data from 203 patients who underwent liver resection for CRLM between January 2014 and September 2023. Overall survival (OS) and disease-free survival (DFS) risk factors were analyzed.
Results : Significant shorter OS was observed in the groups with age > 70, preoperative PNI (Prognostic Nutritional Index) < 40, preoperative CA19-9 > 25 U/ml, intraoperative blood loss > 1000 ml, positive surgical margins(SM+), and Cavien-Dindo >grade 3a postoperative complications group. Significant shorter DFS was observed in the groups with preoperative PNI <40, concomitant liver metastases, liver metastases >5 on preoperative imaging, metastases in both sides of the liver, liver metastases > 5 in pathological diagnosis, SM+, occurrence of Cavien-Dindo >grade 3a complications, resected liver weight exceeding 30% of the standard liver volume, and intraoperative blood loss > 1000 ml. In multivariate analysis, age > 70, preoperative PNI < 40, preoperative CA19-9 > 25 U/ml, and SM+ were significantly associated with shorter OS. For DFS, preoperative PNI < 40, metastases in both sides of the liver, and more than five liver metastases based on preoperative imaging were significantly associated with shorter DFS.
Conclusions : This study indicates that a preoperative PNI below 40 increases is the risk factor for both OS and DFS, and positive surgical margins are linked to shorter OS. Improving preoperative nutrition, reducing liver volume and metastases with chemotherapy, and minimizing intraoperative blood loss and postoperative complications might improve prognosis.
Methods : This retrospective study analyzed data from 203 patients who underwent liver resection for CRLM between January 2014 and September 2023. Overall survival (OS) and disease-free survival (DFS) risk factors were analyzed.
Results : Significant shorter OS was observed in the groups with age > 70, preoperative PNI (Prognostic Nutritional Index) < 40, preoperative CA19-9 > 25 U/ml, intraoperative blood loss > 1000 ml, positive surgical margins(SM+), and Cavien-Dindo >grade 3a postoperative complications group. Significant shorter DFS was observed in the groups with preoperative PNI <40, concomitant liver metastases, liver metastases >5 on preoperative imaging, metastases in both sides of the liver, liver metastases > 5 in pathological diagnosis, SM+, occurrence of Cavien-Dindo >grade 3a complications, resected liver weight exceeding 30% of the standard liver volume, and intraoperative blood loss > 1000 ml. In multivariate analysis, age > 70, preoperative PNI < 40, preoperative CA19-9 > 25 U/ml, and SM+ were significantly associated with shorter OS. For DFS, preoperative PNI < 40, metastases in both sides of the liver, and more than five liver metastases based on preoperative imaging were significantly associated with shorter DFS.
Conclusions : This study indicates that a preoperative PNI below 40 increases is the risk factor for both OS and DFS, and positive surgical margins are linked to shorter OS. Improving preoperative nutrition, reducing liver volume and metastases with chemotherapy, and minimizing intraoperative blood loss and postoperative complications might improve prognosis.
SESSION
E-poster
E-Session 03/21 ALL DAY