BACKGROUND: When hepatectomy is used as a primary treatment for liver metastasis from colorectal cancer (CRCLM), the balance between surgical curability and functional preservation of the remnant liver is of great importance. METHODS: A total of 108 patients who underwent initial hepatectomy for CRCLM were retrospectively analyzed with respect to tumor extent, operative method, and prognosis, including recurrence. RESULTS: The 1-, 2-, 3-, and 5-year overall survival rates (OS) for all patients were 90.5%, 77.8%, 63.2%, and 51.6%, respectively. Multivariate analysis indicated serum carbohydrate antigen 19-9 (CA 19-9) level after hepatectomy (<36 or ≥36 mAU/mL) and presence of recurrence as independent prognostic factors of OS (P = 0.0458 and 0.0249, respectively), and tumor depth of colorectal cancer (<se (a2) vs. ≥se (a2)) and serum CA 19-9 level after hepatectomy as the significant factors affecting disease-free survival (DFS) (P = 0.0025 and 0.00138, respectively). Neither resection margin nor type of hepatectomy (anatomic or nonanatomic) for CRCLM was a significant prognostic factor for OS or DFS or CRCLM recurrence, including intrahepatic recurrence. CONCLUSIONS: In CRCLM, we believe that nonanatomic hepatectomy with narrow margin is indicated, and optimal treatment would include functional preservation of as much of the remnant liver as possible.
BACKGROUND: When hepatectomy is used as a primary treatment for liver metastasis from colorectal cancer (CRCLM), the balance between surgical curability and functional preservation of the remnant liver is of great importance. METHODS: A total of 108 patients who underwent initial hepatectomy for CRCLM were retrospectively analyzed with respect to tumor extent, operative method, and prognosis, including recurrence. RESULTS: The 1-, 2-, 3-, and 5-year overall survival rates (OS) for all patients were 90.5%, 77.8%, 63.2%, and 51.6%, respectively. Multivariate analysis indicated serum carbohydrate antigen 19-9 (CA 19-9) level after hepatectomy (<36 or ≥36 mAU/mL) and presence of recurrence as independent prognostic factors of OS (P = 0.0458 and 0.0249, respectively), and tumor depth of colorectal cancer (<se (a2) vs. ≥se (a2)) and serum CA 19-9 level after hepatectomy as the significant factors affecting disease-free survival (DFS) (P = 0.0025 and 0.00138, respectively). Neither resection margin nor type of hepatectomy (anatomic or nonanatomic) for CRCLM was a significant prognostic factor for OS or DFS or CRCLM recurrence, including intrahepatic recurrence. CONCLUSIONS: In CRCLM, we believe that nonanatomic hepatectomy with narrow margin is indicated, and optimal treatment would include functional preservation of as much of the remnant liver as possible.
Authors: Chandrakanth Are; Mithat Gonen; Kathleen Zazzali; Ronald P Dematteo; William R Jarnagin; Yuman Fong; Leslie H Blumgart; Michael D'Angelica Journal: Ann Surg Date: 2007-08 Impact factor: 12.969
Authors: James S Tomlinson; William R Jarnagin; Ronald P DeMatteo; Yuman Fong; Peter Kornprat; Mithat Gonen; Nancy Kemeny; Murray F Brennan; Leslie H Blumgart; Michael D'Angelica Journal: J Clin Oncol Date: 2007-10-10 Impact factor: 44.544
Authors: Toshifumi Wakai; Yoshio Shirai; Jun Sakata; Vladimir A Valera; Pavel V Korita; Kouhei Akazawa; Yoichi Ajioka; Katsuyoshi Hatakeyama Journal: Ann Surg Oncol Date: 2008-07-02 Impact factor: 5.344
Authors: Umut Sarpel; Anthony S Bonavia; Alexis Grucela; Sasan Roayaie; Myron E Schwartz; Daniel M Labow Journal: Ann Surg Oncol Date: 2008-11-20 Impact factor: 5.344