Outcome after hepatectomy for multiple (four or more) colorectal metastases in the era of effective chemotherapy Journal Article
| Authors: | Kornprat, P.; Jarnagin, W. R.; Gonen, M.; DeMatteo, R. P.; Fong, Y.; Blumgart, L. H.; D'Angelica, M. |
| Article Title: | Outcome after hepatectomy for multiple (four or more) colorectal metastases in the era of effective chemotherapy |
| Abstract: | BACKGROUND: Hepatic resection is generally accepted as the only potential for long-term survival in patients with colorectal metastases confined to the liver. Despite an unknown benefit, hepatic resection is playing an increasing role in patients with extensive disease. METHODS: A retrospective review of a prospectively maintained hepatobiliary surgical database was carried out. Outcome after hepatectomy for four or more colorectal hepatic metastases was reviewed. RESULTS: Between 1998 and 2002, out of a total of 584 patients, 98 (17%) with four or more colorectal hepatic metastases were resected. Actuarial 5-year survival was 33% for the entire group, with seven actual 5-year survivors. There were no perioperative deaths, and the perioperative morbidity was 28%. Positive margins and extrahepatic disease resection were independently associated with poor outcome. The median disease-free survival was 12 months, with no actuarial disease-free survivors at 5 years. Recurrence pattern, response to neoadjuvant chemotherapy, time to recurrence, and resection of recurrent disease were also associated with outcome. CONCLUSIONS: Long-term survival can be achieved after resection of multiple colorectal metastases; however, because most patients will experience recurrence of disease, effective adjuvant therapy and close follow-up is necessary. |
| Keywords: | adult; treatment outcome; aged; aged, 80 and over; middle aged; survival rate; retrospective studies; multimodality cancer therapy; liver neoplasms; adjuvant therapy; chemotherapy, adjuvant; combined modality therapy; neoadjuvant therapy; follow up; follow-up studies; lymph node metastasis; antineoplastic agent; lymphatic metastasis; metastasis; neoplasm recurrence, local; antineoplastic combined chemotherapy protocols; pathology; retrospective study; colorectal neoplasms; cancer invasion; colorectal tumor; tumor recurrence; adjuvant chemotherapy; liver tumor; liver resection; hepatectomy; neoplasm invasiveness |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 14 |
| Issue: | 3 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2007-03-01 |
| Start Page: | 1151 |
| End Page: | 1160 |
| Language: | English |
| PUBMED: | 17195913 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 42" - "Export Date: 17 November 2011" - "Source: Scopus" |
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