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Abstract The pattern of relapse and factors influencing the site of recurrent disease were studied in 68 patients subjected to liver resection of colorectal metastases. Fifty‐three (78%) patients had recurrence. Liver, lungs, and peritoneal cavity were most frequently involved, and all patients with relapse had recurrence in one or more of these sites. Intraabdominal relapse occurred in 50 (74%) patients (94% of patients with relapse). The liver was involved in 44 (65%) patients and was the only site of recurrence in 19 (28%). Extrahepatic metastases developed in 34 (50%) patients. Four or more liver tumors, a resection margin of less than 10 mm, and extrahepatic disease were the main determinants of hepatic recurrence. Bilateral intrahepatic spread, as compared to unilateral disease, major liver resection, as compared to wedge resection, and percent liver tumor volume were also associated with an increased risk of liver recurrence. The presence of extrahepatic disease before resection was the only factor that could be demonstrated to increase the risk of (further) extrahepatic spread. It is concluded that the number of liver metastases, the resection margin, and the presence or absence of extrahepatic disease helps in predicting the risk of hepatic recurrence after resection for colorectal liver cancer. No variable presently available is of any help, however, in predicting the extrahepatic recurrence affecting about half of the patients having no evidence of extrahepatic disease before liver resection. This finding should urge improved evaluation of candidates for liver resection and should influence adjuvant treatment protocols .
Ekberg et al. (Sat,) studied this question.