Anatomic segmental hepatic resection is superior to wedge resection as an oncologic operation for colorectal liver metastases Journal Article
| Authors: | DeMatteo, R. P.; Palese, C.; Jarnagin, W. R.; Sun, R. L.; Blumgart, L. H.; Fong, Y. |
| Article Title: | Anatomic segmental hepatic resection is superior to wedge resection as an oncologic operation for colorectal liver metastases |
| Abstract: | Hepatic wedge resection for colorectal liver metastasis has been reported to have a high incidence of positive surgical margins. Anatomic segmental resection is now widely practiced, although there are few data comparing segmental and wedge resection in terms of tumor clearance or long-term outcome. There were 267 patients who underwent liver resection for metastatic colorectal cancer between July 1985 and October 1998 at our institution who had either a wedge (n = 119) or segmental (n = 148) resection. Patient, tumor, and treatment data were compared, actuarial survival was determined, and prognostic factors were analyzed. Anatomic segmental resection was associated with similar blood loss, operative time, and complications as wedge resection. Segmental resection had a significantly lower rate of positive margins (2% vs. 16%) compared to wedge hepatectomy (P <0.001). On univariate analysis, segmentectomy resulted in longer survival with a median of 53 months vs. 38 months for wedge hepatectomy (P = 0.015). Preoperative carcinoembryonic antigen level, positive margin of resection, and the presence of extrahepatic disease independently predicted survival on multivariate analysis. Anatomic segmental resection is a safe procedure and is superior to wedge resection as an oncologic operation for colorectal liver metastasis because it results in better tumor clearance and improved survival. |
| Keywords: | survival; adult; treatment outcome; aged; aged, 80 and over; disease-free survival; middle aged; survival analysis; mortality; liver neoplasms; united states; comparative study; disease free survival; methodology; adenocarcinoma; metastasis; pathology; colorectal neoplasms; colorectal tumor; liver tumor; outcome; liver resection; new york city; hepatectomy; wedge resection; colorectal metastases; humans; human; male; female; article; segmentectomy |
| Journal Title: | Journal of Gastrointestinal Surgery |
| Volume: | 4 |
| Issue: | 2 |
| ISSN: | 1091-255X |
| Publisher: | Springer |
| Date Published: | 2000-04-01 |
| Start Page: | 178 |
| End Page: | 184 |
| Language: | English |
| PUBMED: | 10675241 |
| PROVIDER: | scopus |
| DOI: | 10.1016/S1091-255X(00)80054-2 |
| DOI/URL: | |
| Notes: | Presented at the 40th Annual Meeting of The Society for Surgery of Alimentary Tract, Orlando, FL, 1999 May 16-19 -- Export Date: 18 November 2015 -- Source: Scopus |
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