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Published in: Digestive Diseases and Sciences 11/2010

01-11-2010 | Original Article

Timing of Resection for Synchronous Liver Metastases from Colorectal Cancer

Authors: Masaki Kaibori, Shigeyoshi Iwamoto, Morihiko Ishizaki, Kosuke Matsui, Takamichi Saito, Kazuhiko Yoshioka, Yoshinori Hamada, A. Hon Kwon

Published in: Digestive Diseases and Sciences | Issue 11/2010

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Abstract

Background

This study aimed to compare the surgical outcome and long-term survival between simultaneous and delayed resection of liver metastases from colorectal cancer (LM), and to identify the factors influencing hepatic disease-free survival in patients with synchronous LM.

Methods

Seventy-four patients with LM were divided into two groups, i.e., 32 patients who underwent hepatectomy at the time of colorectal surgery (simultaneous group) and 42 patients who underwent delayed liver resection (delayed group).

Results

The hepatic disease-free survival rates of patients from the delayed group with either ≥3 or <3 liver metastases were significantly better than that of the simultaneous group. Multivariate analysis showed that simultaneous resection was one of three independent prognostic indicators with an influence on hepatic disease-free survival. In 13 of the 42 (31%) patients from the delayed group, new metastatic lesions were found in the same and/or different segments after re-evaluation during the interval between operations. These patients had a higher incidence of poorly differentiated or mucinous adenocarcinoma, shorter interval between procedures, and larger tumors than patients without tumor progression.

Conclusions

Tumor progression could be recognized and occult metastases were detected during the interval between operations. Delayed resection of synchronous LM may be useful to reduce the risk of rapid recurrence in the remnant liver. Patients with poorly differentiated or mucinous adenocarcinoma and those with larger tumors who undergo delayed liver resection should receive neoadjuvant chemotherapy during the interval between operations.
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Metadata
Title
Timing of Resection for Synchronous Liver Metastases from Colorectal Cancer
Authors
Masaki Kaibori
Shigeyoshi Iwamoto
Morihiko Ishizaki
Kosuke Matsui
Takamichi Saito
Kazuhiko Yoshioka
Yoshinori Hamada
A. Hon Kwon
Publication date
01-11-2010
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 11/2010
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-009-1124-6

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