BACKGROUND: Hepatic resection for colorectal liver metastasis (CLM) with concomitant extrahepatic disease (EHD) is a controversial topic. We sought to evaluate the long-term outcome of patients undergoing liver resection for CLM in presence of EHD and identify factors associated with prognosis. METHODS: From 1996 to 2007, a total of 1629 patients who underwent resection of CLM were identified from an international multi-institutional database. One hundred seventy-one patients (10.4%) underwent resection of EHD. Clinicopathologic and outcome data were collected and analyzed by univariate and multivariate analyses. RESULTS: Median number of treated CLM was 2 (range, 1-18); most patients had solitary EHD (n = 114; 66.6%) a single anatomic site of EHD (n = 153; 89.4%). The 5-year survival for patients with EHD was 26% compared with 58% for those without EHD (P < 0.001). Recurrence was common (84%). Among patients with EHD, R1 margin status, multiple EHD sites, and location of EHD were associated with worse survival (all P < 0.05). Patients with multiple EHD sites or aortocaval lymph node metastasis had a 5-year survival of 14% and 7%, respectively. When survival was stratified by the total number of metastases treated, the presence of EHD still had a prognostic impact, but the relative impact of EHD diminished as the total number of metastases treated increased. CONCLUSION: Concurrent resection of hepatic and EHD in well-selected patients may provide the possibility of long-term survival. The risk of recurrence, however, remains high, and a worse outcome is associated with both number of metastases and location of EHD.
BACKGROUND: Hepatic resection for colorectal liver metastasis (CLM) with concomitant extrahepatic disease (EHD) is a controversial topic. We sought to evaluate the long-term outcome of patients undergoing liver resection for CLM in presence of EHD and identify factors associated with prognosis. METHODS: From 1996 to 2007, a total of 1629 patients who underwent resection of CLM were identified from an international multi-institutional database. One hundred seventy-one patients (10.4%) underwent resection of EHD. Clinicopathologic and outcome data were collected and analyzed by univariate and multivariate analyses. RESULTS: Median number of treated CLM was 2 (range, 1-18); most patients had solitary EHD (n = 114; 66.6%) a single anatomic site of EHD (n = 153; 89.4%). The 5-year survival for patients with EHD was 26% compared with 58% for those without EHD (P < 0.001). Recurrence was common (84%). Among patients with EHD, R1 margin status, multiple EHD sites, and location of EHD were associated with worse survival (all P < 0.05). Patients with multiple EHD sites or aortocaval lymph node metastasis had a 5-year survival of 14% and 7%, respectively. When survival was stratified by the total number of metastases treated, the presence of EHD still had a prognostic impact, but the relative impact of EHD diminished as the total number of metastases treated increased. CONCLUSION: Concurrent resection of hepatic and EHD in well-selected patients may provide the possibility of long-term survival. The risk of recurrence, however, remains high, and a worse outcome is associated with both number of metastases and location of EHD.
Authors: Hari Nathan; John F Bridges; David P Cosgrove; Luis A Diaz; Daniel A Laheru; Joseph M Herman; Richard D Schulick; Barish H Edil; Christopher L Wolfgang; Michael A Choti; Timothy M Pawlik Journal: Ann Surg Oncol Date: 2012-08-09 Impact factor: 5.344
Authors: A J Hyde; R Nassabein; A AlShareef; D Armstrong; S Babak; S Berry; D Bossé; E Chen; B Colwell; C Essery; R Goel; R Goodwin; S Gray; N Hammad; A Jeyakuymar; D Jonker; P Karanicolas; N Lamond; R Letourneau; J Michael; N Patil; E Powell; R Ramjeesingh; W Saliba; R Singh; S Snow; T Stuckless; S Tadros; M Tehfé; M Thana; M Thirlwell; M Vickers; K Virik; S Welch; T Asmis Journal: Curr Oncol Date: 2019-10-01 Impact factor: 3.677
Authors: Liliane Mpabanzi; Kim M C van Mierlo; Massimo Malagó; Cornelis H C Dejong; Dimitrios Lytras; Steven W M Olde Damink Journal: HPB (Oxford) Date: 2012-10-22 Impact factor: 3.647