Survival after resection of multiple bilobar hepatic metastases from colorectal carcinoma

Bolton, J. S. and Fuhrman, G. M. (2000). Survival after resection of multiple bilobar hepatic metastases from colorectal carcinoma. In: 111th Annual Meeting of the Southern Surgical Association, Hot Springs, VA, United States, (743-750). 5-8 December 1999. doi:10.1097/00000658-200005000-00015


Author Bolton, J. S.
Fuhrman, G. M.
Title of paper Survival after resection of multiple bilobar hepatic metastases from colorectal carcinoma
Conference name 111th Annual Meeting of the Southern Surgical Association
Conference location Hot Springs, VA, United States
Conference dates 5-8 December 1999
Journal name Annals of Surgery   Check publisher's open access policy
Publisher Lippincott Williams & Wilkins
Publication Year 2000
Sub-type Fully published paper
DOI 10.1097/00000658-200005000-00015
ISSN 0003-4932
1528-1140
Volume 231
Issue 5
Start page 743
End page 750
Total pages 7
Language eng
Abstract/Summary Objective: To define the long-term outcome and treatment complications for patients undergoing liver resection for multiple, bilobar hepatic metastases from colorectal cancer. Methods: A retrospective analysis of 165 consecutive patients undergoing liver resection for metastatic colorectal cancer was performed. Patients were divided into a simple hepatic metastasis group, consisting of patients with three or fewer metastases in a unilobar distribution, and a complex hepatic metastases group, consisting of patients with four or more unilobar metastases or at least two bilobar metastases. Results: The 5-year survival rate was 36% for the simple group and 37% for the complex group. Multivariate analysis revealed that the number of hepatic segments involved by tumor and the maximum diameter of the largest metastasis correlated significantly with the 5-year survival rate. The surgical death rate was 4.9% for the simple group and 9.1% for the complex group; this difference was not significant. Multivariate analysis revealed that extended lobar resection and concomitant colon and hepatic resection were significant and independent predictors of surgical death. The combination of extended lobar resection and concomitant colon resection was used significantly more frequently in the complex group than in the simple group. Conclusions: Resection of complex hepatic metastases, as defined in this study, results in a 5-year survival rate of 37% and confers the same survival benefit as does resection of limited hepatic metastases. The surgical death rate for this aggressive approach is significantly higher if extended lobar resections are necessary and if concomitant colorectal resection is performed. Patients who have complex hepatic metastases at the time of diagnosis of the primary colorectal cancer and who would require extended hepatic lobectomy should have hepatic resection delayed for at least 3 months after colon resection.
Keyword SYNCHRONOUS LIVER METASTASES
CANCER
SURGERY
Q-Index Code E1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Conference Paper
Collection: School of Medicine Publications
 
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Created: Mon, 14 Mar 2011, 10:49:20 EST