Background:

Surgery has become a well-established treatment with curative intent in patients with colorectal liver metastases (CLM). Combined with oncological treatment and a multimodal approach, an increasing number of patients have been included for surgery during the last decade. It is estimated that 15-20% of the patients with advanced colorectal cancer (stage IV) and CLM are offered resection. Even with a recurrence rate of 60-70 %, the five-year overall survival rate has reached 40-50% due to an aggressive multimodal treatment and repeated resections. Despite a documented increasing lifespan in this highly selected group, less is studied about quality of life after such treatment. The purpose of our project has been to examine factors affecting outcome after surgery for CLM (I/II). Secondly we want to evaluate health related quality of life (HQoL) following this treatment (III).

Method:

Paper I/II:A combined retrospective (1998 to 2008) and prospective (2009 to 2014) cohort study of consecutive patients with CLM treated with primary resection at Haukeland University Hospital. The data are retrieved from the patient medical record.

Paper III: A prospective survey of the same patient cohort investigating HQoL (2011-2014). Patients are recruited by completing a validated questionnaire preoperatively (baseline), and after three, six and twelve months postoperatively. The study is registered and accepted in clinicaltrials.gov.

Results:

Paper I (accepted):

Surgery for colorectal liver metastases: the impact of resection margins on recurrence and overall survival Jon-Helge Angelsen, Arild Horn, Geir Egil Eide, Asgaut Viste. World Journal of Surgical Oncology 2014, 12:127 (27 April 2014)

Main findings: R1 resections (microscopically positive margins) for colorectal liver metastases predict adverse outcome. RMs below 5 mm increased the risk for LR and shortened the time to recurrence. Preoperative chemotherapy did not alter an adverse outcome in R1 vs. R0 patients.

Paper II: (being drafted):

Patterns and sites of recurrence after primary resection for colorectal liver metastases Jon-Helge Angelsen, Asgaut Viste, Geir Egil Eide, Dag Hoem, Arild Horn

The purpose of this paper is to study patients with recurrent disease after resection for CLM according to sites of recurrence and the following treatment. We also want to assess whether preoperative clinicopathological parameters may predict the extent of recurrent disease.

Paper III: (recruiting patients)

Health related Quality of Life after surgery for colorectal liver metastases

Primary endpoint: Time from surgery (for CLM) to achieve the preoperative HQoL (baseline).

Secondary endpoints: Identify possible clinical parameters influencing the HQoL after liver resection.