Clinical features and prognosis in hepatectomy for colorectal cancer with centrally located liver metastasis

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• 作者：I-Ming Kuo (1)
  Song-Fong Huang (1)
  Jy-Ming Chiang (2)
  Chien-Yuh Yeh (2)
  Kun-Ming Chan (1)
  Jinn-Shiun Chen (2)
  Ming-Chin Yu (1)
  
  1. Division of General Surgery ; Department of Surgery ; Chang Gung Memorial Hospital ; Linkou ; Chang Gung University ; 5 ; Fu-Shin Street ; Kweishan ; Taoyuan ; 333 ; Taiwan
  2. Division of Colorectal Surgery ; Department of Surgery ; Chang Gung Memorial Hospital ; Linkou ; Chang Gung University ; 5 ; Fu-Shin Street ; Kweishan ; Taoyuan ; 333 ; Taiwan
  
• 关键词：Colorectal cancer ; Liver metastasis ; Hepatectomy ; Centrally located ; Prognosis
• 刊名：World Journal of Surgical Oncology
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：13
• 期：1
• 全文大小：1,232 KB
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• 刊物主题：Surgical Oncology;
• 出版者：BioMed Central
• ISSN：1477-7819

文摘

Background Hepatic metastasectomy for patients with primary colorectal cancer offers better long-term outcome, and chemotherapy can increase the rate of hepatic resectability for patients with initially inoperable disease. The pattern of liver metastasis and status of the primary tumor are rarely discussed in the analysis of long-term outcome. In this report, we evaluate the influence of the pattern of metastasis on clinical features and prognosis. Methods One hundred and fifty-nine patients who underwent hepatic metastasectomy with curative intent for liver metastasis of colorectal cancer between October 1991 and December 2006 were enrolled. Patients were grouped according to whether liver metastasis was centrally or peripherally located, based on imaging and operative findings. Patient demographics, characteristics of the primary and metastatic tumors, and surgical outcomes were analyzed for long-term survival. Results A greater proportion of patients with centrally located metastases were male, as compared with those with peripherally located metastases. Compared with patients with peripherally located metastases, patients with centrally located metastases were more likely to have multiple lesions (P = 0.016), involvement of multiple segments (P = 0.006), large metastases (P P Conclusions In colorectal cancer, centrally located liver metastasis represents a poor prognostic factor after hepatectomy, and is associated with early recurrence. Neoadjuvant chemotherapy may be used to downstage centrally located liver metastases to improve outcome.