Resection of liver metastases from colorectal cancer: Are there any truly significant clinical prognosticators? (original) (raw)

Abstract

PURPOSE: This study was designed to evaluate the prognostic significance of various prognostic factors affecting recurrence after resection of colorectal hepatic metastases. PATIENTS AND METHODS: Records of 54 patients who had hepatic resection between 1986 and 1993 for metastatic liver tumor from colorectal cancer were reviewed. Factors analyzed were those reported to be of prognostic significance in other studies, including gender, primary tumor site, Dukes stage, diagnostic interval, grade, preoperative carcinoembryonic antigen (CEA) level, number of metastases, size of metastases, distribution of metastases, type of resection, resection margin, and estimated blood loss. RESULTS: Average follow-up of surviving patients was 28 (range, 12–89) months. Average survival time from date of hepatic resection was 26 months, with an estimated actuarial survival rate of 25.5 percent at five years. Using the multivariate analysis of factors, gender and preoperative CEA level were shown to be significantly related to overall survival (P=0.0455 and 0.054, respectively). Cancer of the right side colon had significant correlation with hepatic “recurrence” (P=0.0071). CONCLUSIONS: Female patients and those with preoperative CEA values higher than 20 ng/ml have a better chance of survival following hepatic resection. Cancer of the right colon has a greater tendency for hepatic recurrence than that of the left colon.

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References

  1. Silen W. Hepatic resection for metastases from colorectal carcinoma is of dubious value. Arch Surg 1989;124:1021–2.
    PubMed Google Scholar
  2. Scheele J, Stangl R, Altendorf-Hofmann A. Hepatic metastases from colorectal carcinoma: impact of surgical resection on the natural history. Br J Surg 1990;77:1241–6.
    PubMed Google Scholar
  3. Adson MA. Resection of liver metastases: when is it worth-while? World J Surg 1987;11:511–20.
    PubMed Google Scholar
  4. Hughes KS. Resection of the liver for colorectal carcinoma metastases: a multi-institutional study of indications for resection. Surg 1988;103:278–88.
    Google Scholar
  5. Nordlinger B, Quilichini M-A, Parc R, Hannoun L, Delva E, Huguet C. Hepatic resection for colorectal liver metastases: influence on survival of preoperative factors and surgery for recurrences in 80 patients. Ann Surg 1987;205:256–63.
    PubMed Google Scholar
  6. Stone MD, Cady B, Jenkins RL, Mc Dermott WV, Steele GD Jr. Surgical therapy for recurrent liver metastases from colorectal cancer. Arch Surg 1990;125:718–22.
    PubMed Google Scholar
  7. Iwatsuki S, Starzl TE. Personal experience with 411 hepatic resections. Ann Surg 1988;208:421–34.
    PubMed Google Scholar
  8. Ekberg H, Tranberg KG, Anderson R. Pattern of recurrence in liver resection for colorectal secondaries. World J Surg 1987;11:541–7.
    PubMed Google Scholar
  9. van Ooijen B, Wiggers T, Meijer S,et al. Hepatic resections for colorectal metastases in the Netherlands: a multiinstitutional 10-year study. Cancer 1992;70:28–34.
    PubMed Google Scholar
  10. Butler J, Attiyeh FF, Daly J. Hepatic resection for metastases of the colon and rectum. Surg Gynecol Obstet 1986;162:109–14.
    PubMed Google Scholar
  11. Cady B, McDermott WV. Major hepatic resection for metachronous metastases from colon cancer. Ann Surg 1985;201:204–1.
    PubMed Google Scholar
  12. Vogt P, Raab R, Ringe B, Pichlmayr R. Resection of synchronous liver metastases from colorectal cancer. World J Surg 1991;15:62–7.
    PubMed Google Scholar
  13. Scheele J, Stangl R, Altendorf-Hofmann A. Indicators of prognosis after hepatic resection for colorectal secondaries. Surgery 1991;110:13–29.
    PubMed Google Scholar
  14. Hohenberger P, Schlag PM, Gerneth T, Herfarth C. Pre- and postoperative carcinoembryonic antigen determinations in hepatic resection for colorectal metastases: predictive value and implications for adjuvant treatment based on multivariate analysis. Ann Surg 1994;219:135–43.
    PubMed Google Scholar
  15. Cady B, Stone MD. The role of surgical resection of liver metastases in colorectal carcinoma. Semin Oncol 1991;18:399–406.
    PubMed Google Scholar
  16. Steele G, Rarikumar TS. Resection of hepatic metastases from colorectal cancer: biological perspectives. Ann Surg 1989;210:127–38.
    PubMed Google Scholar
  17. Cady B, Stone MD, Mc Dermott WV. Technical and biological factors in disease-free survival after hepatic resection for colorectal cancer metastases. Arch Surg 1992;127:561–9.
    PubMed Google Scholar
  18. Bozzetti F, Bignami P, Montalto F, Doci R, Gennari L. Repeated hepatic resection for recurrent metastases from colorectal cancer. Br J Surg 1992;79:146–8.
    PubMed Google Scholar
  19. Hughes KS, Simon R, Songhorabodi S,et al. Resection of the liver for colorectal carcinoma metastases: a multiinstitutional study of patterns of recurrence. Surg 1986;100:278–84.
    Google Scholar
  20. Wagner JS, Adson MA, van Heerden JA, Adson MH, Ilstrup DM. The natural history of hepatic metastases from colorectal cancer: a comparison with resective treatment. Ann Surg 1984;199:502–7.
    PubMed Google Scholar

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Author notes

  1. Jeng Yi Wang M.D.
    Present address: Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung College of Medicine, Chang Gung Memorial Hospital, 199, Tung Hwa North Road, Taipei, Taiwan, Republic of China

Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung College of Medicine, Chang Gung Memorial Hospital, 199, Tung Hwa North Road, Taipei, Taiwan, Republic of China
    Jy-Ming Chiang M.D., Long-Bin Jeng M.D., Chung Rong Changchien M.D., Jinn Shiun Chen M.D. & Kuan Cheng Hsu M.D.

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  1. Jeng Yi Wang M.D.
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  2. Jy-Ming Chiang M.D.
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  3. Long-Bin Jeng M.D.
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  4. Chung Rong Changchien M.D.
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  5. Jinn Shiun Chen M.D.
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  6. Kuan Cheng Hsu M.D.
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Wang, J.Y., Chiang, JM., Jeng, LB. et al. Resection of liver metastases from colorectal cancer: Are there any truly significant clinical prognosticators?.Dis Colon Rectum 39, 847–851 (1996). https://doi.org/10.1007/BF02053981

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