Survival after resection of multiple hepatic colorectal metastases Journal Article

Authors: Weber, S. M.; Jarnagin, W. R.; DeMatteo, R. P.; Blumgart, L. H.; Fong, Y.
Article Title: Survival after resection of multiple hepatic colorectal metastases
Abstract: Background: Hepatic resection is potentially curative in selected patients with colorectal metastases. It is a widely held practice that multiple colorectal hepatic metastases are not resected, although outcome after removal of four or more metastases is not well defined. Methods: Patients with four or more colorectal hepatic metastases who submitted to resection were identified from a prospective database. Number of metastases was determined by serial sectioning of the gross specimen at the time of resection. Demographic data, tumor characteristics, complications, and survival were analyzed. Results: From August 1985 to September 1998, 155 patients with four or more metastatic tumors (range 4-20) underwent potentially curative resection by extended hepatectomy (39%), lobectomy (42%), or multiple segmental resections (19%). Operative morbidity and mortality were 26% and 1%, respectively. Actuarial 5-year survival was 23% for the entire group (median = 32 months) and there were 12 actual 5-year survivors. On multivariate analysis, only number of hepatic tumors (P = .005) and the presence of a positive margin (P = .003) were independent predictors of poor survival. Conclusions: Hepatic resection in patients with four or more colorectal metastases can achieve long-term survival although the results are less favorable as the number of tumors increases. Number of hepatic metastases alone should not be used as a sole contraindication to resection, but it is clear that the majority of patients will not be cured after resection of multiple lesions.
Keywords: adult; treatment outcome; aged; survival analysis; cancer surgery; survival rate; major clinical study; clinical trial; liver neoplasms; prospective studies; colorectal cancer; postoperative complication; colorectal neoplasms; liver metastasis; severity of illness index; liver resection; new york city; liver cancer; middle age; prognosis; human; male; female; article; liver neoplasm; colorectal hepatic metastases
Journal Title: Annals of Surgical Oncology
Volume: 7
Issue: 9
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2000-10-01
Start Page: 643
End Page: 650
Language: English
PUBMED: 11034240
PROVIDER: scopus
DOI: 10.1007/s10434-000-0643-3
Notes: Presented at the 53rd Annual Meeting of the Society of Surgical Oncology, 2000 March 16–19, New Orleans, LA -- Export Date: 18 November 2015 -- Source: Scopus
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MSK Authors
  1. Leslie H Blumgart
    349 Blumgart
  2. Ronald P DeMatteo
    623 DeMatteo
  3. Sharon M Weber
    12 Weber
  4. William R Jarnagin
    617 Jarnagin
  5. Yuman Fong
    755 Fong