Early Recurrence After Initial Hepatectomy For Colorectal Liver Metastases

Objective: This study investigated the frequency of early recurrence in patients who had undergone hepatectomy for colorectal cancer liver metastasis (CRLM) and assessed the indications for adjuvant chemotherapy in these patients.Methods: This retrospective analysis included 133 consecutive patients who underwent initial hepatectomy for CRLM between April 2000 and May 2010 and have been followed more than 5 years.Results: Of the 133 patients, 83 (62%) experienced tumor recurrence, with 14 of the 83 recurrences within 6 months after initial hepatectomy. Overall survival was significantly poorer in patients with recurrences within 6 months than those without any recurrence (P = 0.015). The frequency of adjuvant chemotherapy was significantly lower in patients with recurrences within 6 months than those without recurrences within 6 months. Multivariate analysis showed that H-2 classification was the only independent risk factor for recurrence within 6 months after hepatectomy (P = 0.002). Adjuvant chemotherapy improved prognosis in patients classified as H2.Conclusions: Patients who experienced tumor recurrence within 6 months after initial hepatectomy for CRLM had a poorer prognosis than patients who experienced recurrence after 6 months. Patients with H2-classification of CRLM should receive preoperative adjuvant chemotherapy.