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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 3/2007

01-03-2007

Outcome After Hepatectomy for Multiple (Four or More) Colorectal Metastases in the Era of Effective Chemotherapy

Authors: Peter Kornprat, MD, William R. Jarnagin, MD, FACS, Mithat Gonen, PhD, Ronald P. DeMatteo, MD, FACS, Yuman Fong, MD, FACS, Leslie H. Blumgart, MD, FACS, FRCS, Michael D’Angelica, MD, FACS

Published in: Annals of Surgical Oncology | Issue 3/2007

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Abstract

Background

Hepatic resection is generally accepted as the only potential for long-term survival in patients with colorectal metastases confined to the liver. Despite an unknown benefit, hepatic resection is playing an increasing role in patients with extensive disease.

Methods

A retrospective review of a prospectively maintained hepatobiliary surgical database was carried out. Outcome after hepatectomy for four or more colorectal hepatic metastases was reviewed.

Results

Between 1998 and 2002, out of a total of 584 patients, 98 (17%) with four or more colorectal hepatic metastases were resected. Actuarial 5-year survival was 33% for the entire group, with seven actual 5-year survivors. There were no perioperative deaths, and the perioperative morbidity was 28%. Positive margins and extrahepatic disease resection were independently associated with poor outcome. The median disease-free survival was 12 months, with no actuarial disease-free survivors at 5 years. Recurrence pattern, response to neoadjuvant chemotherapy, time to recurrence, and resection of recurrent disease were also associated with outcome.

Conclusions

Long-term survival can be achieved after resection of multiple colorectal metastases; however, because most patients will experience recurrence of disease, effective adjuvant therapy and close follow-up is necessary.
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Metadata
Title
Outcome After Hepatectomy for Multiple (Four or More) Colorectal Metastases in the Era of Effective Chemotherapy
Authors
Peter Kornprat, MD
William R. Jarnagin, MD, FACS
Mithat Gonen, PhD
Ronald P. DeMatteo, MD, FACS
Yuman Fong, MD, FACS
Leslie H. Blumgart, MD, FACS, FRCS
Michael D’Angelica, MD, FACS
Publication date
01-03-2007
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 3/2007
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-006-9068-y

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