Liver resections for colorectal cancer metastases
Keywords:colorectal neoplasms, neoplasm metastasis, liver, hepatectomy, human
AIM: Colorectal cancer is the second most common cancer in the Western world. Surgery is currently the only curative method of treatment.
METHODS: Age, gender, the number and size of the largest metastases, distribution according to Gennari, as well as the type of liver resection according to the timing of metastasis detection were assessed for 51 patients who underwent liver resections. Overall 3-year survivals were compared.
RESULTS: Gender (p=0.223), age (p=0.243), number (p=0.120) and distribution (p=0.516) of metastases did not significantly influence survival. Patients with the largest metastasis 5 cm or less than in diameter had significantly greater 3-year survival rate compared to those with metastases larger than 5 cm (65.7% vs. 30%, p=0.034). Simultaneous resections of colorectal cancer and liver metastases were associated with significantly longer survival compared to delayed resections (69.7% vs. 44.7%, p=0.018).
CONCLUSION: Liver resection for colorectal cancer metastases is justifiable and safe even in older patients. Metastases over 5 cm and delayed resections were associated with shorter survival. In the multivariate survival model, among these factors, simultaneous resection of synchronous metastases was found to be the only significant factor influencing 3-year survival.
2. Stangl R, Altendorf-Hofmann A, Charnley RM, Scheele J. Factors influencing the natural history of colorectal liver metastases. Lancet (London, England). 1994;343(8910):1405-1410.
3. Bengmark S, Hafstrom L. The natural history of primary and secondary malignant tumors of the liver. I. The prognosis for patients with hepatic metastases from colonic and rectal carcinoma by laparotomy. Cancer. 1969;23(1):198-202.
4. Nakamura S, Suzuki S, Baba S. Resection of liver metastases of colorectal carcinoma. World journal of surgery. 1997;21(7):741-747.
5. Fong Y, Cohen AM, Fortner JG, Enker WE, Turnbull AD, Coit DG, Marrero AM, Prasad M, Blumgart LH, Brennan MF. Liver resection for colorectal metastases. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 1997;15(3):938-946.
6. Kemeny N, Fata F. Hepatic-arterial chemotherapy. The Lancet Oncology. 2001;2(7):418-428.
7. Onik G, Rubinsky B, Zemel R, Weaver L, Diamond D, Cobb C, Porterfield B. Ultrasound-guided hepatic cryosurgery in the treatment of metastatic colon carcinoma. Preliminary results. Cancer. 1991;67(4):901-907.
8. Imamura H, Kawasaki S. Treatment strategy for multiple hepatic metastases of colorectal carcinoma. Journal of hepato-biliary-pancreatic surgery. 1999;6(1):23-29.
9. Gennari L, Doci R, Bignami P, Bozzetti F. Surgical treatment of hepatic metastases from colorectal cancer. Annals of surgery. 1986;203(1):49-54.
10. Fujita S, Akasu T, Moriya Y. Resection of synchronous liver metastases from colorectal cancer. Japanese journal of clinical oncology. 2000;30(1):7-11.
11. Fernandez E, Bosetti C, La Vecchia C, Levi F, Fioretti F, Negri E. Sex differences in colorectal cancer mortality in Europe, 1955-1996. European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP). 2000;9(2):99-104.
12. Slattery ML, Potter JD, Curtin K, Edwards S, Ma KN, Anderson K, Schaffer D, Samowitz WS. Estrogens reduce and withdrawal of estrogens increase risk of microsatellite instability-positive colon cancer. Cancer research. 2001;61(1):126-130.
13. Wichmann MW, Muller C, Hornung HM, Lau-Werner U, Schildberg FW, Colorectal Cancer Study G. Gender differences in long-term survival of patients with colorectal cancer. The British journal of surgery. 2001;88(8):1092-1098.
14. Zieren HU, Muller JM, Zieren J. Resection of colorectal liver metastases in old patients. Hepato-gastroenterology. 1994;41(1):34-37.
15. Scheele J, Altendorf-Hofmann A. Resection of colorectal liver metastases. Langenbeck's archives of surgery. 1999;384(4):313-327.
16. Bakalakos EA, Kim JA, Young DC, Martin EW, Jr. Determinants of survival following hepatic resection for metastatic colorectal cancer. World journal of surgery. 1998;22(4):399-404; discussion 404-395.
17. Nakamura S, Suzuki S, Konno H. Resection of hepatic metastases of colorectal carcinoma: 20 years' experience. Journal of hepato-biliary-pancreatic surgery. 1999;6(1):16-22.
18. Yamaguchi J, Yamamoto M, Komuta K, Fujioka H, Furui JI, Kanematsu T. Hepatic resections for bilobar liver metastases from colorectal cancer. Journal of hepato-biliary-pancreatic surgery. 2000;7(4):404-409.
19. Iwatsuki S, Esquivel CO, Gordon RD, Starzl TE. Liver resection for metastatic colorectal cancer. Surgery. 1986;100(4):804-810.
20. Doci R, Gennari L, Bignami P, Montalto F, Morabito A, Bozzetti F. One hundred patients with hepatic metastases from colorectal cancer treated by resection: analysis of prognostic determinants. The British journal of surgery. 1991;78(7):797-801.
21. Rosen CB, Nagorney DM, Taswell HF, Helgeson SL, Ilstrup DM, van Heerden JA, Adson MA. Perioperative blood transfusion and determinants of survival after liver resection for metastatic colorectal carcinoma. Annals of surgery. 1992;216(4):493-504; discussion 504-495.
22. Machi J, Isomoto H, Kurohiji T, Yamashita Y, Shirouzu K, Kakegawa T, Sigel B, Zaren HA, Sariego J. Accuracy of intraoperative ultrasonography in diagnosing liver metastasis from colorectal cancer: evaluation with postoperative follow-up results. World journal of surgery. 1991;15(4):551-556; discussion 557.
23. Ekberg H, Tranberg KG, Andersson R, Lundstedt C, Hagerstrand I, Ranstam J, Bengmark S. Determinants of survival in liver resection for colorectal secondaries. The British journal of surgery. 1986;73(9):727-731.
24. Yedibela S, Reck T, Hohenberger W. [Resection of liver metastases--goal, timing and results]. Therapeutische Umschau Revue therapeutique. 2001;58(12):713-717.
25. Doko M, Zovak M, Ledinsky M, Mijic A, Peric M, Kopljar M, Culinovic R, Rode B, Doko B. Safety of simultaneous resections of colorectal cancer and liver metastases. Collegium antropologicum. 2000;24(2):381-390.
26. Lyass S, Zamir G, Matot I, Goitein D, Eid A, Jurim O. Combined colon and hepatic resection for synchronous colorectal liver metastases. Journal of surgical oncology. 2001;78(1):17-21.
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