BACKGROUND: Timing of hepatectomy for synchronous metastases of colorectal cancer is still debated. The aim of this retrospective study was to analyze prognostic factors after synchronous and delayed liver resections to define selection criteria for choosing timing of hepatectomy. METHODS: The study was performed on 127 patients with synchronous metastases undergoing radical hepatectomy. We divided patients according to the timing of hepatectomy: 70 synchronous (group A) and 57 delayed (group B). RESULTS: Overall survival was similar between the two groups (5-year survival 30.8% vs. 32.0% A vs. B, P = .406). The multivariate analysis evidenced four independent prognostic factors in group A: male sex (P = .04), T4 (P = .0035), more than three metastases (P = .0001), and metastatic infiltration of nearby structures (P < .0001). There were no statistically significant prognostic factors in group B. Patients with more than three metastases had a significantly worse survival in group A than in group B (3-year survival, 15.0% vs. 34.3%, P = .007); similarly, borderline significant difference was encountered in patients with T4 primary tumor (3-year survival, 16.7% vs. 60%, P = .064) CONCLUSIONS: Patients with liver metastases synchronous with colorectal cancer with T4 primary tumor, metastasis infiltration of neighboring structures, and especially with more than three metastases should receive neoadjuvant chemotherapy before liver resection.
BACKGROUND: Timing of hepatectomy for synchronous metastases of colorectal cancer is still debated. The aim of this retrospective study was to analyze prognostic factors after synchronous and delayed liver resections to define selection criteria for choosing timing of hepatectomy. METHODS: The study was performed on 127 patients with synchronous metastases undergoing radical hepatectomy. We divided patients according to the timing of hepatectomy: 70 synchronous (group A) and 57 delayed (group B). RESULTS: Overall survival was similar between the two groups (5-year survival 30.8% vs. 32.0% A vs. B, P = .406). The multivariate analysis evidenced four independent prognostic factors in group A: male sex (P = .04), T4 (P = .0035), more than three metastases (P = .0001), and metastatic infiltration of nearby structures (P < .0001). There were no statistically significant prognostic factors in group B. Patients with more than three metastases had a significantly worse survival in group A than in group B (3-year survival, 15.0% vs. 34.3%, P = .007); similarly, borderline significant difference was encountered in patients with T4 primary tumor (3-year survival, 16.7% vs. 60%, P = .064) CONCLUSIONS:Patients with liver metastases synchronous with colorectal cancer with T4 primary tumor, metastasis infiltration of neighboring structures, and especially with more than three metastases should receive neoadjuvant chemotherapy before liver resection.
Authors: Eduardo de Santibañes; Diego Fernandez; Carlos Vaccaro; Guillermo Ojea Quintana; Fernando Bonadeo; Juan Pekolj; Carlos Bonofiglio; Ernesto Molmenti Journal: World J Surg Date: 2010-09 Impact factor: 3.352
Authors: Stefano Ferretti; Hadrien Tranchart; Joseph F Buell; Constantino Eretta; Alberto Patriti; Marcello Giuseppe Spampinato; Jung Wook Huh; Luca Vigano; Ho Seong Han; Giuseppe Maria Ettorre; Elio Jovine; Thomas Clark Gamblin; Giulio Belli; Go Wakabayashi; Brice Gayet; Ibrahim Dagher Journal: World J Surg Date: 2015-08 Impact factor: 3.352
Authors: Luca Viganò; Mehdi Karoui; Alessandro Ferrero; Claude Tayar; Daniel Cherqui; Lorenzo Capussotti Journal: World J Surg Date: 2011-12 Impact factor: 3.352
Authors: Francesco M Polignano; Aaron J Quyn; Pandanaboyana Sanjay; Nikola A Henderson; Iain S Tait Journal: Surg Endosc Date: 2012-03-22 Impact factor: 4.584