Five‐year survival post hepatectomy for colorectal liver metastases in a real‐world Chinese cohort: Recurrence patterns and prediction for potential cure

BACKGROUND: Patients with a 5‐year recurrence‐free survival post liver resection for colorectal cancer liver metastases (CRLM) are considered to be potentially cured. However, there is a deficit of data on long‐term follow‐up and the recurrence status among these patients in the Chinese population. We analyzed real‐world follow‐up data of patients with CRLM who underwent hepatectomy, explored the recurrence patterns, and established a prediction model for a potential cure scenario. METHODS: Patients who underwent radical hepatic resection for CRLM during 2000–2016, with actual follow‐up data for at least 5 years, were enrolled. The observed survival rate was calculated and compared among the groups with different recurrence patterns. The predictive factors for 5‐year non‐recurrence were determined using logistic regression analysis; a recurrence‐free survival model was developed to predict long‐term survival. RESULTS: A total of 433 patients were included, of whom 113 patients were found non‐recurrence after 5 years follow‐up, with a potential cure rate of 26.1%. Patients with late recurrence (>5 months) and lung relapse showed significantly superior survival. Repeated localized treatment significantly improved the long‐term survival of patients with intrahepatic or extrahepatic recurrences. Multivariate analysis showed that RAS wild‐type CRC, preoperative CEA <10 ng/ml, and liver metastases ≤3 were independent factors for a 5‐year disease‐free recurrence. A cure model was developed based on the above factors, achieving good performance in predicting long‐term survival. CONCLUSIONS: About one quarter patients with CRLM could achieve potential cure with non‐recurrence at 5‐year after surgery. The recurrence‐free cure model could well distinguish the long‐term survival, which would aid clinicians in determining the treatment strategy.