TY - JOUR
T1 - Liver Metastases from Colorectal Cancer
T2 - Present Surgical Approach
AU - Cavallari, Antonino
AU - Vivarelli, Marco
AU - Bellusci, Roberto
AU - Montalti, Roberto
AU - De Ruvo, Nicola
AU - Cucchetti, Alessandro
AU - De Vivo, Antonio
AU - De Raffele, Emilio
AU - Salone, MariaCristina
AU - La Barba, Giuliano
PY - 2003/11
Y1 - 2003/11
N2 - Background/Aims: New developments in surgical techniques and strategies are modifying the indications to resection of liver metastases. Methodology: From January 1986 to December 2000, 246 consecutive patients with colorectal liver metastases underwent curative hepatic resection. Surgical strategies included simultaneous resection of primary and metastatic colorectal tumor, re-resection of colorectal liver recurrences, two-stage resection and resection of the inferior vena cava when involved by the tumor. Disease-free survival in relation to clinical, pathological and surgical factors was retrospectively assessed with univariate and multivariate analyses. Results: The overall operative mortality was 0.8%. The 1-, 3- and 5-year disease-free survival rates were 75%, 47% and 40%, respectively. Tumors larger than 7 centimeters, multiple lesions, tumors involving more than 2 segments and those requiring major hepatectomy had a worse prognosis at univariate analysis. A size of the tumor above 7 centimeters was the only independent prognostic factors at multivariate analysis. Two-stage and inferior vena cava resection increased operability; re-resection of recurrent colorectal secondaries prolonged survival. Conclusions: Resection of colorectal liver metastases is safe and effective; it should be considered the treatment of choice for this disease and proposed even for advanced lesions. Counseling of the hepatobilary surgeon should be asked for once a liver secondary is detected in the preoperative work-up of a colorectal cancer.
AB - Background/Aims: New developments in surgical techniques and strategies are modifying the indications to resection of liver metastases. Methodology: From January 1986 to December 2000, 246 consecutive patients with colorectal liver metastases underwent curative hepatic resection. Surgical strategies included simultaneous resection of primary and metastatic colorectal tumor, re-resection of colorectal liver recurrences, two-stage resection and resection of the inferior vena cava when involved by the tumor. Disease-free survival in relation to clinical, pathological and surgical factors was retrospectively assessed with univariate and multivariate analyses. Results: The overall operative mortality was 0.8%. The 1-, 3- and 5-year disease-free survival rates were 75%, 47% and 40%, respectively. Tumors larger than 7 centimeters, multiple lesions, tumors involving more than 2 segments and those requiring major hepatectomy had a worse prognosis at univariate analysis. A size of the tumor above 7 centimeters was the only independent prognostic factors at multivariate analysis. Two-stage and inferior vena cava resection increased operability; re-resection of recurrent colorectal secondaries prolonged survival. Conclusions: Resection of colorectal liver metastases is safe and effective; it should be considered the treatment of choice for this disease and proposed even for advanced lesions. Counseling of the hepatobilary surgeon should be asked for once a liver secondary is detected in the preoperative work-up of a colorectal cancer.
KW - Colorectal cancer
KW - Liver metastases
KW - Surgical treatment
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M3 - Article
C2 - 14696466
AN - SCOPUS:10744231099
VL - 50
SP - 2067
EP - 2071
JO - Acta hepato-splenologica
JF - Acta hepato-splenologica
SN - 0172-6390
IS - 54
ER -