Not all early recurrences define futility: relapse patterns shape outcomes after colorectal liver metastases resection.

Authors

Rebecca Marino, Buonanno Silvia, Catena Marco, Remo Alessandris, Emanuele Mini, Federica Cipriani, Luca Ruotolo, Chiara Bonini, Francesca Ratti

Published in

HPB : the official journal of the International Hepato Pancreato Biliary Association. Sep 22, 2026. Epub Sep 22, 2026.

Abstract

Recurrence after curative resection of colorectal liver metastases (CRLM) is heterogeneous. Early recurrence not always implies futile surgery. This study distinguishes predictors of early recurrence versus futile surgery and examines recurrence patterns.
This study analyzed the prospective LiMeT cohort of patients undergoing curative-intent resection for CRLM at IRCCS San Raffaele. Early recurrence was defined as <12 months and futile surgery as Time-to-Surgical-Failure (TSF) < 12 months (unresectable recurrence, progression, or death). Logistic regression identified predictors, and Sankey analysis mapped recurrence characteristics.
Two hundred twenty-eight patients were included: 74 without recurrence, 115 early recurrences, and 39 late recurrences. Early recurrence was independently associated with synchronous CRLM (OR1.56, p = 0.02), primary tumor N1-N2 stage (OR2.23, p < 0.01), KRAS mutation (OR2.40, p = 0.024), ≥5 CRLM (OR2.15, p < 0.01), and metastatic diameter ≥3 cm (OR2.19, p < 0.01). Futility was associated with age>65, T4 stage, KRAS mutation, and no adjuvant chemotherapy. Sankey analysis showed that early recurrence not always leads to futility, often remaining liver-limited or oligometastatic.
Early recurrence and futile surgery represent distinct forms of postoperative failure. Early recurrence reflects tumor burden and biology, whereas futility identifies relapse that becomes unresectable or fatal, negating benefit. TSF provides complementary information on the durability of surgical benefit.

PMID:
42838793
Bibliographic data and abstract were imported from PubMed on 07 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.