OBJECTIVES: We set out to clarify the clinicopathologic characteristics of colorectal liver metastases with macroscopic intrabiliary tumor growth and to determine optimal surgical management. METHODS: Over 15 years, 6 of 103 patients undergoing hepatectomy for colorectal liver metastases had macroscopic intrabiliary tumor growth and were analyzed retrospectively. RESULTS: We performed 11 operations for the 6 patients, consisting of 10 hepatectomies (including 1 hepatopancreatoduodenectomy) and 1 pancreatoduodenectomy. Three patients survived more than 5 years: 1 died of pulmonary emphysema with no sign of recurrence 101 months after initial hepatectomy; the 2 others were alive with no sign of recurrence at 74 and 145 months after initial hepatectomy. Median survival time of all 6 patients was 87.5 months. Histologically, intrabiliary tumor growth had two components: intraluminal and intraepithelial extension. In the proximal direction, distance between these two components ranged from 4-10 mm. CONCLUSION: Aggressive surgical treatment can improve chances of long-term survival for patients with macroscopic intrabiliary growth of colorectal liver metastasis. Although nonanatomic limited resection is a common procedure for colorectal liver metastasis, anatomic hepatobiliary resection is recommended.
OBJECTIVES: We set out to clarify the clinicopathologic characteristics of colorectal liver metastases with macroscopic intrabiliary tumor growth and to determine optimal surgical management. METHODS: Over 15 years, 6 of 103 patients undergoing hepatectomy for colorectal liver metastases had macroscopic intrabiliary tumor growth and were analyzed retrospectively. RESULTS: We performed 11 operations for the 6 patients, consisting of 10 hepatectomies (including 1 hepatopancreatoduodenectomy) and 1 pancreatoduodenectomy. Three patients survived more than 5 years: 1 died of pulmonary emphysema with no sign of recurrence 101 months after initial hepatectomy; the 2 others were alive with no sign of recurrence at 74 and 145 months after initial hepatectomy. Median survival time of all 6 patients was 87.5 months. Histologically, intrabiliary tumor growth had two components: intraluminal and intraepithelial extension. In the proximal direction, distance between these two components ranged from 4-10 mm. CONCLUSION: Aggressive surgical treatment can improve chances of long-term survival for patients with macroscopic intrabiliary growth of colorectal liver metastasis. Although nonanatomic limited resection is a common procedure for colorectal liver metastasis, anatomic hepatobiliary resection is recommended.
Authors: Y Muramatsu; K Takayasu; Y Furukawa; K Miyakawa; R Iwata; K Ushio; J Yamamoto; Y Nakanishi Journal: Radiology Date: 1997-10 Impact factor: 11.105
Authors: Y Fong; A M Cohen; J G Fortner; W E Enker; A D Turnbull; D G Coit; A M Marrero; M Prasad; L H Blumgart; M F Brennan Journal: J Clin Oncol Date: 1997-03 Impact factor: 44.544
Authors: K Okano; J Yamamoto; T Okabayashi; Y Sugawara; K Shimada; T Kosuge; S Yamasaki; H Furukawa; Y Muramatsu Journal: Br J Radiol Date: 2002-06 Impact factor: 3.039
Authors: K S Hughes; R Simon; S Songhorabodi; M A Adson; D M Ilstrup; J G Fortner; B J Maclean; J H Foster; J M Daly; D Fitzherbert Journal: Surgery Date: 1986-08 Impact factor: 3.982
Authors: Jimme K Wiggers; Wouter W Te Riele; Tristan H van Dongen; Joanne Verheij; Olivier R C Busch; Thomas M van Gulik Journal: Hepatobiliary Surg Nutr Date: 2016-08 Impact factor: 7.293
Authors: Jeannelyn S Estrella; Mohammad L Othman; Melissa W Taggart; Stanley R Hamilton; Steven A Curley; Asif Rashid; Susan C Abraham Journal: Am J Surg Pathol Date: 2013-10 Impact factor: 6.394