Resection of the liver for colorectal carcinoma metastases - A multi-institutional study of long-term survivors Journal Article


Authors: Hughes, K. S.; Rosenstein, R. B.; Songhorabodi, S.; Adson, M. A.; Ilstrup, D. M.; Fortner, J. G.; Maclean, B. J.; Foster, J. H.; Daly, J. M.; Fitzherbert, D.; Sugarbaker, P. H.; Iwatsuki, S.; Starzl, T.; Ramming, K. P.; Longmire, W. P. Jr; O'Toole, K.; Petrelli, N. J.; Herrera, L.; Cady, B.; McDermott, W.; Nims, T.; Enker, W. E.; Coppa, G. F.; Blumgart, L. H.; Bradpiece, H.; Urist, M.; Aldrete, J. S.; Schlag, P.; Hohenberger, P.; Steele, G. Jr; Hodgson, W. J.; Hardy, T. G.; Harbora, D.; McPherson, T. A.; Lim, C.; Dillon, D.; Happ, R.; Ripepi, P.; Villella, E.; Smith, W.; Rossi, R. L.; Remine, S. G.; Oster, M.; Connolly, D. P.; Abrams, J.; Al-Jurf, A.; Hobbs, K. E. F.; Li, M. K. W.; Howard, T.; Lee, E.
Article Title: Resection of the liver for colorectal carcinoma metastases - A multi-institutional study of long-term survivors
Abstract: In this review of a collected series of patients undergoing hepatic resection for colorectal metastases, 100 patients were found to have survived greater than five years from the time of resection. Of these 100 long-term survivors, 71 remain disease-free through the last follow-up, 19 recurred prior to five years, and ten recurred after five years. Patient characteristics that may have contributed to survival were examined. Procedures performed included five trisegmentectomies, 32 lobectomies, 16 left lateral segmentectomies, and 45 wedge resections. The margin of resection was recorded in 27 patients, one of whom had a positive margin, nine of whom had a less than or equal to 1-cm margin, and 17 of whom had a greater than 1-cm margin. Eighty-one patients had a solitary metastasis to the liver, 11 patients had two metastases, one patient had three metastases, and four patients had four metastases. Thirty patients had Stage C primary carcinoma, 40 had Stage B primary carcinoma, and one had Stage A primarycarcinoma. The disease-free interval from the time of colon resection to the time of liver resection was less than one year in 65 patients, and greater than one year in 34 patients. Three patients had bilobar metastases. Four of the patients had extrahepatic disease resected simultaneously with the liver resection. Though several contraindications to hepatic resection have been proposed in the past, five-year survival has been found in patients with extrahepatic disease resected simultaneously, patients with bilobar metastases, patients with multiple metastases, and patients with positive margins. Five-year disease-free survivors are also present in each of these subsets. It is concluded that five-year survival is possible in the presence of reported contraindications to resection, and therefore that the decision to resect the liver must be individualized. © 1988 American Society of Colon and Rectal Surgeons.
Keywords: adult; aged; retrospective studies; major clinical study; liver neoplasms; follow up; colorectal cancer; colonic neoplasms; colorectal neoplasms; liver metastasis; liver resection; hepatectomy; rectal neoplasms; hepatic metastases; hepatic resection; middle age; cancer; prognosis; human; male; female; priority journal; support, non-u.s. gov't
Journal Title: Diseases of the Colon and Rectum
Volume: 31
Issue: 1
ISSN: 0012-3706
Publisher: Lippincott Williams & Wilkins  
Date Published: 1988-01-01
Start Page: 1
End Page: 4
Language: English
DOI: 10.1007/bf02552560
PUBMED: 3366020
PROVIDER: scopus
PMCID: PMC3058509
DOI/URL:
Notes: Article -- Export Date: 6 August 2020 -- Source: Scopus
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  1. Joseph G Fortner
    38 Fortner
  2. Warren E. Enker
    70 Enker
  3. John M. Daly
    57 Daly