In a retrospective cohort of 109 patients undergoing liver resection for colorectal liver metastases, high tumor burden, major intraoperative blood loss, T3/T4 primary disease, and RAS mutation were associated with early recurrence. Selected patients undergoing salvage re-hepatectomy had favorable long-term survival, but small subgroups and strong selection bias prevent causal conclusions.
Key findings
- More than four metastases predicted recurrence by six months (HR 3.526; p=0.008) and 12 months (HR 3.115; p=0.004). Blood loss above 1,000 mL was associated with six-month (HR 3.356; p=0.004) and 12-month recurrence (HR 2.171; p=0.041); T3/T4 disease (HR 6.513; p=0.011) and RAS mutation (HR 2.740; p=0.006) predicted 12-month recurrence.
Why this matters globally
The reported factors may inform postoperative surveillance and multicenter research on salvage surgery, but they do not yet constitute an externally validated prediction tool.
Thai researcher contribution
Phramongkutklao Hospital surgeons analyzed more than a decade of clinical experience, linking recurrence risk with treatment pathways after recurrence.
Limitations to consider
This small single-center retrospective study spans changing practice from 2013 to 2024 and its models may overfit. Salvage-surgery recipients were selected by fitness, disease pattern, and treatment response; non-significant p-values do not establish survival equivalence with patients who never recurred.