European Journal of Cancer (2014) xxx, xxx– xxx

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Systematic review of outcomes of patients undergoing resection for colorectal liver metastases in the setting of extra hepatic disease q Michael Hwang a, Thejus T. Jayakrishnan a, Danielle E. Green a, Ben George b, James P. Thomas b, Ryan T. Groeschl a, Beth Erickson c, Sam G. Pappas d, T. Clark Gamblin a, Kiran K. Turaga a,⇑ a

Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, United States Division of Medical Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States c Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, United States d Division of Surgical Oncology, Department of Surgery, Loyola University Medical Center, Maywood, IL, United States b

Received 19 February 2014; received in revised form 8 March 2014; accepted 18 March 2014

KEYWORDS Colorectal cancer Colorectal liver metastases Extra hepatic metastases Hepatic resection

Abstract Background: Surgical resection for patients with colorectal liver metastases (CRLM) can offer patients a significant survival benefit. We hypothesised that patients with CRLM and extra hepatic disease (EHD) undergoing metastasectomy had comparable survival and describe outcomes based on the distribution of metastatic disease. Methods: A systematic search using a predefined registered protocol was undertaken between January 2003 and June 2012. Primary exposure was hepatic resection for CRLM and primary outcome measure was overall survival. Meta-regression techniques were used to analyse differences between patients with and without extra hepatic disease. Findings: From a pool of 4996 articles, 50 were retained for data extraction (3481 CRLM patients with EHD). The median survival (MS) was 30.5 (range, 9–98) months which was achieved with an operative mortality rate of 0–4.2%. The 3-year and 5-year overall survival (OS) were 42.4% (range, 20.6–77%) and 28% (range, 0–61%) respectively. Patients with EHD of the lungs had a MS of 45 (range, 39–98) months versus lymph nodes (portal and para-aortic) 26 (range, 21–48) months versus peritoneum 29 (range, 18–32) months. The

q This study was presented at the 66th Annual Cancer Symposium of the Society of Surgical Oncology at National Harbor, MD (March 6–9, 2013). ⇑ Corresponding author: Address: 9200W Wisconsin Ave, Milwaukee, WI 53226, United States. Tel.: +1 414 805 5078; fax: 414-805-5771. E-mail address: [email protected] (K.K. Turaga).

http://dx.doi.org/10.1016/j.ejca.2014.03.277 0959-8049/Ó 2014 Elsevier Ltd. All rights reserved.

Please cite this article in press as: Hwang M. et al., Systematic review of outcomes of patients undergoing resection for colorectal liver metastases in the setting of extra hepatic disease, Eur J Cancer (2014), http://dx.doi.org/10.1016/j.ejca.2014.03.277

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M. Hwang et al. / European Journal of Cancer xxx (2014) xxx–xxx

MS also varied by the amount of liver disease – 42.2 months (

Systematic review of outcomes of patients undergoing resection for colorectal liver metastases in the setting of extra hepatic disease.

Surgical resection for patients with colorectal liver metastases (CRLM) can offer patients a significant survival benefit. We hypothesised that patien...
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