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01-12-2006

Second Hepatectomy for Recurrent Colorectal Liver Metastasis: Analysis of Preoperative Prognostic Factors

Authors: Seiji Ishiguro, MD, Takayuki Akasu, MD, Yoshiya Fujimoto, MD, Junji Yamamoto, MD, Yoshihiro Sakamoto, MD, Tsuyoshi Sano, MD, Kazuaki Shimada, MD, Tomoo Kosuge, MD, Seiichiro Yamamoto, MD, Shin Fujita, MD, Yoshihiro Moriya, MD

Published in: Annals of Surgical Oncology | Issue 12/2006

Abstract

Background

Second hepatectomy is a potentially curative treatment for patients with hepatic recurrence of colorectal cancer. However, there is still no consensus about the patient selection criteria for second hepatectomy under these circumstances, and the factors affecting prognosis after second hepatectomy remain uncertain.

Methods

Clinicopathologic data for 111 consecutive patients with colorectal liver metastasis who underwent second hepatectomy at a single institution between 1985 and 2004, and for whom complete clinicopathologic reports were available, were subjected to univariate and multivariate analyses.

Results

The morbidity and mortality rates were 14% and 0%, respectively, and the overall 5-year survival rate was 41%. Multivariate analysis revealed that synchronous resection for the first liver metastasis (hazard ratio, 1.8), more than three tumors at the second hepatectomy (1.9), and histopathological involvement of the hepatic vein and/or portal vein by the first liver metastasis (1.7) were independently associated with poor survival. We used these three risk factors to devise a preoperative model for predicting survival. The 5-year survival rates of patients without any risk factors, and with one, two, or three risk factors, were 62%, 38%, 19%, and 0%, respectively.

Conclusions

Second hepatectomy is beneficial for patients without any risk factors. Before second hepatectomy, chemotherapy should be considered for patients with any of these risk factors, especially with two or three factors, in the adjuvant or neoadjuvant setting to prolong survival. These results need to be confirmed and validated in another data set or future prospective trial according to the scoring scheme we outline.

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Title: Second Hepatectomy for Recurrent Colorectal Liver Metastasis: Analysis of Preoperative Prognostic Factors
Authors: Seiji Ishiguro, MD
Takayuki Akasu, MD
Yoshiya Fujimoto, MD
Junji Yamamoto, MD
Yoshihiro Sakamoto, MD
Tsuyoshi Sano, MD
Kazuaki Shimada, MD
Tomoo Kosuge, MD
Seiichiro Yamamoto, MD
Shin Fujita, MD
Yoshihiro Moriya, MD
Publication date: 01-12-2006
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 12/2006
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-006-9067-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Second Hepatectomy for Recurrent Colorectal Liver Metastasis: Analysis of Preoperative Prognostic Factors

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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