Análisis de supervivencia e Identificación de factores pronósticos tras cirugía curativa de metástasis hepáticas de cáncer colorrectal.

Abstract

INTRODUCTION \nLiver resection is the only curative treatment for colorectal liver metastasis (CRLM). The identification of predictive factors leads to personalize patient management to enhance their long-term outcomes. This population-based study aimed to characterize factors associated with, and survival impact of patients who received hepatectomy for colorectal liver metastasis (CRLM). \n \nPATIENTS AND METHODS \nA retrospective cohort study of all the hepatectomies for colorectal liver metastasis (CRLMs) performed at third-level hospital of Spain (2010-2018) was conducted. The Kaplan-Meier method was used for survival analyses. Multivariable Cox and regression models were used to determine prognostic factors associated with overall survival (OS). \n \nRESULTS \nThe 5-year overall survival (OS) and disease-free survival (DFS) were 42 and 33%, respectively. Survival analysis showed that metastasis features (number, largest size, distribution, and extrahepatic disease) and postsurgical factors (transfusion, major complications, and positive margin resection), as well as non-mutated KRAS, showed a significant association with survival. Otherwise, on multivariate analysis, only five independent risk factors were identified: major size metastasis > 4cm, RAS mutation, positive margin resection, intraoperative transfusion, and major complications. \n \nCONCLUSIONS \nAccording to our findings, major size metastasis > 4 cm, intraoperative transfusion, and major postoperative complications continue to be traditional prognostic factors. Meanwhile, the KRAS biomarker has a powerful impact as a survival prognostic factor.