| Abstract | BACKGROUND: Although retrospective studies have demonstrated survival benefit from hepatectomy for metastatic colorectal cancer, few studies have examined patients with multiple bilobar metastases to identify survival-related factors throughout their course. METHODS: Among 277 patients with R0 resection for liver metastases from colorectal cancer, 79 patients had 4 or more lesions in a bilobar distribution. To determine impact on long-term outcome, we compared clinicopathologic factors retrospectively between 3-year survivors and patients who died less than 3 years after hepatectomy. RESULTS: Among 79 patients with 4 or more bilobar metastases, 5 patients (6.3%) attained prolonged remission after initial hepatectomy. By multivariate analysis, a lack of adjuvant chemotherapy compromised survival (relative risk or RR, 2.21; P = .036), as did prehepatectomy carcinoembryonic antigen exceeding 12 ng/mL (RR, 2.12; P = .039). Treatment-related variables such as repeat resections in the event of liver recurrence (P < .01) or lung metastases (P < .05), as well as adjuvant chemotherapy (P < .01), differed significantly between 3-year survivors and nonsurvivors, as did the differences in number of metastases, maximum size of metastases, concomitant extrahepatic metastases at the time of initial hepatectomy, and disease-free interval preceding initial recurrence. CONCLUSIONS: Although not effective as a sole treatment for multiple hepatic metastases of colorectal cancer, liver resection is important in multimodal therapy. Reoperations for recurrence of metastases, followed by additional chemotherapy, frequently obtained long survival. |
| Authors | Kuniya Tanaka, Hiroshi Shimada, Michio Ueda, Kenichi Matsuo, Itaru Endo, Shinji Togo
(Affiliation: Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.)
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| Journal | Surgery
(Surgery)
Vol. 143
Issue 2
Pg. 259-70
(Feb 2008)
ISSN: 1532-7361 United States |
| PMID | 18242343
(Publication Type: Journal Article)
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| Topics |
- Adult
- Aged
- Colorectal Neoplasms
(pathology, surgery)
- Disease-Free Survival
- Female
- Follow-Up Studies
- Hepatectomy
(methods)
- Humans
- Japan
- Liver Neoplasms
(mortality, secondary, surgery)
- Male
- Middle Aged
- Multivariate Analysis
- Prognosis
- Regression Analysis
- Reoperation
(statistics & numerical data)
- Retrospective Studies
- Survival Analysis
- Time Factors
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