OBJECTIVE: The aim of this study is to determine the absolute contraindication for hepatic resection for colorectal metastases and investigate the value of hepatectomy for gastric metastases by comparing it with the results of colorectal metastases performed with the same criteria. METHODS: A retrospective cohort study was conducted in patients undergoing hepatic resection for metastatic colorectal (n = 64) and gastric (n = 17) carcinomas. Common predictive factors for both metastases were analyzed by the stratified Cox proportional hazard model. In this model, the different baseline hazard was set for each disease, whereas the risk of each covariate was assumed to be equal in both gastric and colorectal metastases. RESULTS: Overall 1-, 2-, and 5-yr survival rates after hepatectomy for colorectal and gastric metastases were 90%, 73%, 42%, and 47%, 22%, 0%, respectively. Factors controlling prognosis were as follows: age > or = 60, extrahepatic metastases, serosal invasion, grade of lymph node metastases, tumor cell differentiation of the primary lesion(s), carcinoembryonic antigen level, tumor-exposed surgical margin, and blood transfusion. In particular, presence of extrahepatic metastases showed the markedly high-risk ratio among these eight variables. CONCLUSIONS: Hepatectomy, if possible, is indicated in patients with hepatic metastases from colorectal carcinoma if there are no extrahepatic metastases and if the primary disease is controlled. It is indicated only in carefully selected patients with metastases from gastric carcinoma.
OBJECTIVE: The aim of this study is to determine the absolute contraindication for hepatic resection for colorectal metastases and investigate the value of hepatectomy for gastric metastases by comparing it with the results of colorectal metastases performed with the same criteria. METHODS: A retrospective cohort study was conducted in patients undergoing hepatic resection for metastatic colorectal (n = 64) and gastric (n = 17) carcinomas. Common predictive factors for both metastases were analyzed by the stratified Cox proportional hazard model. In this model, the different baseline hazard was set for each disease, whereas the risk of each covariate was assumed to be equal in both gastric and colorectal metastases. RESULTS: Overall 1-, 2-, and 5-yr survival rates after hepatectomy for colorectal and gastric metastases were 90%, 73%, 42%, and 47%, 22%, 0%, respectively. Factors controlling prognosis were as follows: age > or = 60, extrahepatic metastases, serosal invasion, grade of lymph node metastases, tumor cell differentiation of the primary lesion(s), carcinoembryonic antigen level, tumor-exposed surgical margin, and blood transfusion. In particular, presence of extrahepatic metastases showed the markedly high-risk ratio among these eight variables. CONCLUSIONS: Hepatectomy, if possible, is indicated in patients with hepatic metastases from colorectal carcinoma if there are no extrahepatic metastases and if the primary disease is controlled. It is indicated only in carefully selected patients with metastases from gastric carcinoma.
Authors: Jong Keun Lim; Joong Bae Ahn; Sung Ha Cheon; Hyun Chang; Jong Yul Jung; Sun Young Rha; Jae Kyung Roh; Sung Hoon Noh; Ho Geun Kim; Hyun Cheol Chung; Hei-Cheul Jeung Journal: Cancer Res Treat Date: 2006-06-30 Impact factor: 4.679
Authors: Marcella Arru; Luca Aldrighetti; Renato Castoldi; Saverio Di Palo; Elena Orsenigo; Marco Stella; Carlo Pulitanò; Francesca Gavazzi; Gianfranco Ferla; Valerio Di Carlo; Carlo Staudacher Journal: World J Surg Date: 2008-01 Impact factor: 3.352
Authors: Mi-Sook Kim; Sung Yul Yoo; Chul Koo Cho; Hyung Jun Yoo; Kwang Mo Yang; Jin Kyu Kang; Dong Han Lee; Jong Inn Lee; Ho Youn Bang; Min Suk Kim; Hae Jin Kang Journal: J Korean Med Sci Date: 2009-06-16 Impact factor: 2.153