| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Original Article |
Hepatobiliary & Pancreatic Surgical Group, Divisions of General Surgery, University Health Network and Mount Sinai Hospital, University of Toronto, 200 Elizabeth Street, Toronto, Ontario, Canada M5G 2C4
Correspondence: Address correspondence and reprint requests to: Steven Gallinger, MD, MSc, FRCSC, Suite 1225, Mount Sinai Hospital, 600 University Ave., Toronto, ON, Canada M5G 1X5; E-mail: sgallinger{at}mtsinai.on.ca.
Background: Metastatic colorectal cancer is a major cause of cancer death in North America. Hepatic resection offers the potential for cure in selected patients. We report the long-term outcomes of patients who underwent hepatic resection for colorectal metastases over a 10-year period at a single hepatobiliary surgical oncology center.
Methods: All patients who underwent liver resection for metastatic colorectal cancer between 1992 and 2002 were identified. Data were retrospectively obtained through chart review. Major outcome variables were disease-free survival and overall survival. Risk factors for disease recurrence and mortality were identified by multivariate analysis by using the Cox proportional hazard method.
Results: A total of 423 hepatectomies were performed for metastatic colorectal cancer. Most operations (n = 276; 65%) were major (four or more segments) hepatectomies. Perioperative morbidity occurred in 74 (17%) patients. There were seven (1.6%) perioperative deaths. The disease-free survival at 1, 5, and 10 years was 64%, 27%, and 22%, respectively. The overall survival at 1, 5, and 10 years was 93%, 47%, and 28%, respectively. Multivariate analysis identified four negative predictive factors for overall survival (hazard ratio; 95% confidence interval): a positive surgical margin (2.9; 1.5–5.3), large metastases (>5 cm; 1.5; 1.1–2.0), multiple metastases (1.4; 1.1–1.9), and age >60 years (1.4; 1.1–1.9).
Conclusions: Hepatic resection for metastatic colorectal cancer is safe and provides good long-term overall survival rates of 47% at 5 years and 28% at 10 years. An aggressive approach is justified by the low operative mortality rate and good long-term survival, even in individuals with multiple bilobar metastases.
Key Words: Liver neoplasm • Colorectal neoplasm • Hepatectomy • Survival • Prognosis • Mortality
This article has been cited by other articles:
 |
|
 |
|
  J. C. C. Tan, N. G. Coburn, N. N. Baxter, A. Kiss, and C. H. L. Law Surgical Management of Intrahepatic Cholangiocarcinoma - A Population-Based Study Ann. Surg. Oncol., February 1, 2008; 15(2): 600 - 608. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Mulier, Y. Ni, J. Jamart, L. Michel, G. Marchal, and T. Ruers Radiofrequency Ablation Versus Resection for Resectable Colorectal Liver Metastases: Time for a Randomized Trial? Ann. Surg. Oncol., January 1, 2008; 15(1): 144 - 157. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Niu, T. D. Yan, J. C. Zhu, D. Black, F. Chu, and D. L. Morris Recurrence and Survival Outcomes after Hepatic Resection with or without Cryotherapy for Liver Metastases from Colorectal Carcinoma Ann. Surg. Oncol., July 1, 2007; 14(7): 2078 - 2087. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J Figueras, F Burdio, E Ramos, J Torras, L Llado, S Lopez-Ben, A Codina-Barreras, and S Mojal Effect of subcentimeter nonpositive resection margin on hepatic recurrence in patients undergoing hepatectomy for colorectal liver metastases. Evidences from 663 liver resections Ann. Onc., July 1, 2007; 18(7): 1190 - 1195. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Ahmad, S. L. Chen, and A. J. Bilchik Role of Repeated Hepatectomy in the Multimodal Treatment of Hepatic Colorectal Metastases Arch Surg, June 1, 2007; 142(6): 526 - 532. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
