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01-04-2004 | Original Article

Results of surgical treatment for multiple (≥5 nodules) bi-lobar hepatic metastases from colorectal cancer

Authors: Hiroshi Shimada, Kuniya Tanaka, Hidenobu Masui, Yasuhiko Nagano, Kenichi Matsuo, Miyuki Kijima, Yasushi Ichikawa, Hideyuki Ike, Shigeo Ooki, Shinji Togo

Published in: Langenbeck's Archives of Surgery | Issue 2/2004

Abstract

Background

The surgery for the treatment of multiple (≥5) bi-lobar hepatic metastases from colorectal cancer is controversial. This retrospective study presents our experience in an attempt to develop reasonable treatment guidelines.

Method

One hundred sixty-one consecutive patients who underwent liver resection with curative intent were classified into three groups: H1 (unilateral), H2 (bilateral, ≤4 nodules), or H3 (bilateral, ≥5 nodules).

Results

The overall cumulative 5-year survival rate was 46.7%. Survival was similar among patients with H1, H2, and H3 disease. Thirty-two patients with H3 disease underwent hepatectomy: straightforward hepatectomy in 12, portal vein embolization (PVE) prior to hepatectomy in eight, two-stage hepatectomy in two, and two-stage hepatectomy combined with PVE in ten. Two-stage hepatectomy with or without PVE was the standard approach in patients with synchronous liver metastases. The operating mortality in hepatectomy for H3 disease was 0%, and the morbidity was 15.2%. The overall response rate to neoadjuvant chemotherapy (NAC) was 41.7% (5/12). Patients who responded to NAC (n=5) had a better prognosis than non-responders (n=7) (P<0.05).

Conclusions

Extended hepatectomy, including preoperative PVE and multi-step hepatectomy, combined with NAC, may result in a favourable prognosis, especially in patients who respond to NAC, but further studies with more patients are needed to confirm this.

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Title: Results of surgical treatment for multiple (≥5 nodules) bi-lobar hepatic metastases from colorectal cancer
Authors: Hiroshi Shimada
Kuniya Tanaka
Hidenobu Masui
Yasuhiko Nagano
Kenichi Matsuo
Miyuki Kijima
Yasushi Ichikawa
Hideyuki Ike
Shigeo Ooki
Shinji Togo
Publication date: 01-04-2004
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 2/2004
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-003-0447-6

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Results of surgical treatment for multiple (≥5 nodules) bi-lobar hepatic metastases from colorectal cancer

Abstract

Background

Method

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Method

Results

Conclusions

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