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- Title
Timing of resection for synchronous liver metastases from colorectal cancer.
- Authors
Kaibori, Masaki; Iwamoto, Shigeyoshi; Ishizaki, Morihiko; Matsui, Kosuke; Saito, Takamichi; Yoshioka, Kazuhiko; Hamada, Yoshinori; Kwon, A.; Kwon, A Hon
- Abstract
<bold>Background: </bold>This study aimed to compare the surgical outcome and long-term survival between simultaneous and delayed resection of liver metastases from colorectal cancer (LM), and to identify the factors influencing hepatic disease-free survival in patients with synchronous LM.<bold>Methods: </bold>Seventy-four patients with LM were divided into two groups, i.e., 32 patients who underwent hepatectomy at the time of colorectal surgery (simultaneous group) and 42 patients who underwent delayed liver resection (delayed group).<bold>Results: </bold>The hepatic disease-free survival rates of patients from the delayed group with either ≥ 3 or <3 liver metastases were significantly better than that of the simultaneous group. Multivariate analysis showed that simultaneous resection was one of three independent prognostic indicators with an influence on hepatic disease-free survival. In 13 of the 42 (31%) patients from the delayed group, new metastatic lesions were found in the same and/or different segments after re-evaluation during the interval between operations. These patients had a higher incidence of poorly differentiated or mucinous adenocarcinoma, shorter interval between procedures, and larger tumors than patients without tumor progression.<bold>Conclusions: </bold>Tumor progression could be recognized and occult metastases were detected during the interval between operations. Delayed resection of synchronous LM may be useful to reduce the risk of rapid recurrence in the remnant liver. Patients with poorly differentiated or mucinous adenocarcinoma and those with larger tumors who undergo delayed liver resection should receive neoadjuvant chemotherapy during the interval between operations.
- Subjects
LIVER metastasis; COLON cancer; ADENOCARCINOMA; HEPATECTOMY; CANCER invasiveness; DRUG therapy; SURGICAL excision; LIVER surgery; LIVER cancer; COLON tumors; COMBINED modality therapy; COMPARATIVE studies; LIVER tumors; RESEARCH methodology; MEDICAL cooperation; MULTIVARIATE analysis; PROGNOSIS; RECTUM tumors; RESEARCH; SURVIVAL analysis (Biometry); TIME; TUMOR classification; EVALUATION research; PROPORTIONAL hazards models
- Publication
Digestive Diseases & Sciences, 2010, Vol 55, Issue 11, p3262
- ISSN
0163-2116
- Publication type
journal article
- DOI
10.1007/s10620-009-1124-6