Impact of the degree of liver resection on survival for patients with multiple liver metastases from colorectal cancer

被引:30
作者
Tanaka, Kuniya [1 ]
Shimada, Hiroshi [1 ]
Matsumoto, Chizuru [1 ]
Matsuo, Kenichi [1 ]
Takeda, Kazuhisa [1 ]
Nagano, Yasuhiko [1 ]
Togo, Shinji [1 ]
机构
[1] Yokohama City Univ, Grad Sch Med, Dept Surg Gastroenterol, Kanazawa Ku, Yokohama, Kanagawa 2360004, Japan
关键词
D O I
10.1007/s00268-008-9610-0
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background Although the degree of hepatic resection has been found to be a key aspect of tumor stimulation, the differences in clinical outcome between a massive liver resection and a less extensive resection for multiple colorectal metastases have not been well studied. The purpose of this study was to clarify the impact of the extent of liver resection on survival outcome. Methods Clinicopathologic data were available for 85 patients who were surgically treated for four or more liver metastases. Forty-nine patients who underwent a major hepatic resection were compared with patients who underwent minor hepatic resections (n = 36). Results As the patients undergoing major resection were more likely to have multiple (p = 0.014) and large tumors (p = 0.021) compared to the minor-resection patients, their overall survival was worse (p = 0.046) and the disease-free rate tended to be poorer. By multivariate analysis of the cohorts, the only independent factor affecting survival was the number of liver tumors (<= 5 or >= 6; relative risk [RR] = 0.427; p = 0.014). When patients with six or more metastases were selected and analyzed, the overall survival of patients who had a major resection was significantly poorer than those who had minor resections (p = 0.028), although the clinical characteristics were comparable between the two groups. Conclusion Although the extent of hepatectomy was not an independent prognosticator, minor resections for multiple colorectal metastases may offer a long-term survival advantage compared to a major resection.
引用
收藏
页码:2057 / 2069
页数:13
相关论文
共 49 条
[1]  
Abdalla EK, 2004, ANN SURG, V239, P818, DOI 10.1097/01.sla.0000128305.90650.71
[2]   Portal vein embolization: rationale, technique and future prospects [J].
Abdalla, EK ;
Hicks, ME ;
Vauthey, JN .
BRITISH JOURNAL OF SURGERY, 2001, 88 (02) :165-175
[3]  
Adam R, 2001, ANN SURG ONCOL, V8, P347
[4]   Two-stage hepatectomy: A planned strategy to treat irresectable liver tumors [J].
Adam, R ;
Laurent, A ;
Azoulay, D ;
Castaing, D ;
Bismuth, H .
ANNALS OF SURGERY, 2000, 232 (06) :777-784
[5]   Analysis of prognostic factors influencing long-term survival after hepatic resection for metastatic colorectal cancer [J].
Arru, Marcella ;
Aldrighetti, Luca ;
Castoldi, Renato ;
Di Palo, Saverio ;
Orsenigo, Elena ;
Stella, Marco ;
Pulitano, Carlo ;
Gavazzi, Francesca ;
Ferla, Gianfranco ;
Di Carlo, Valerio ;
Staudacher, Carlo .
WORLD JOURNAL OF SURGERY, 2008, 32 (01) :93-103
[6]  
ATHOULAY D, 2000, ANN SURG, V231, P480
[7]   CLINICAL PERSPECTIVE OF HUMAN COLORECTAL-CANCER METASTASIS [J].
AUGUST, DA ;
OTTOW, RT ;
SUGARBAKER, PH .
CANCER AND METASTASIS REVIEWS, 1984, 3 (04) :303-324
[8]   Preoperative right portal vein embolization in patients with metastatic liver disease - Metastatic liver volumes after RPVE [J].
Barbaro, B ;
Stasi, CD ;
Nuzzo, G ;
Vellone, M ;
Giuliante, F ;
Marano, P .
ACTA RADIOLOGICA, 2003, 44 (01) :98-102
[9]   Complete response of colorectal liver metastases after chemotherapy:: Does it mean cure? [J].
Benoist, Stephane ;
Brouquet, Antoine ;
Penna, Christophe ;
Julie, Catherine ;
El Hajjam, Mostafa ;
Chagnon, Sophie ;
Mitry, Emmanuel ;
Rougier, Philippe ;
Nordlinger, Bernard .
JOURNAL OF CLINICAL ONCOLOGY, 2006, 24 (24) :3939-3945
[10]   Resection of nonresectable liver metastases from colorectal cancer after neoadjuvant chemotherapy [J].
Bismuth, H ;
Adam, R ;
Levi, F ;
Farabos, C ;
Waechter, F ;
Castaing, D ;
Majno, P ;
Engerran, L .
ANNALS OF SURGERY, 1996, 224 (04) :509-520