Hepatic Resection for Colorectal Metastasis with Macroscopic Tumor Thrombus in the Portal Vein

Tada, Keiichiro; Kokudo, Norihiro; Seki, Makoto; Ueno, Masashi; Azekura, Kaoru; Ohta, Hiroyuki; Yamaguchi, Toshiharu; Matusbara, Toshiki; Takahashi, Takashi; Nakajima, Toshifusa; Yanagisawa, Akio; Muto, Tetsuichiro

doi:10.1007/s00268-002-6716-7

Cited by 32 publications

(38 citation statements)

References 14 publications

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“…Furthermore, local factors can be tumors, surgery, and intra-abdominal inflammation conditions, and incidence due to local factors ranges from 10-50% 3,15) . Macroscopically, the reported incidence of portal vein tumor thrombus similar to that observed in our patient case is 0.4-2.8% 1,2) , so this is a rare case.…”

Section: Discussionsupporting

confidence: 82%

“…Pathological findings of metastatic hepatic tumor originating from colorectal carcinoma typically show microscopic tumor invasion into the intra-hepatic portal vein. However, macroscopic tumor thrombosis occupying the main portal branch is rare in patients with liver metastases with the incidence of macroscopic portal vein tumor thrombosis found to be 0.4-2.8% 1,2) . Nowadays, surgical resection of colorectal liver metastases is the best-known treatment to improve its long-term prognosis.…”

Section: Introductionmentioning

confidence: 99%

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Successful Concomitant Surgery for Abdominoperineal Resection and Right Hepatic Lobectomy with Thrombectomy

Fukino

Oida

Kida

et al. 2011

Nichidai Igaku Zasshi

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Abdominal ultrasonography examination in a 70-year-old man revealed a hepatic mass in the right hepatic lobe. The examination revealed a hepatic tumor with tumor thrombosis in the right portal vein, and rectal carcinoma. To prevent cavernous transformation of the veins, intestinal bleeding, and ascites, we performed concomitant surgery for abdominoperineal resection and right hepatic lobectomy with tumor thrombectomy. The pathological findings of the resected specimens from the rectum and right hepatic lobe showed a moderately differentiated adenocarcinoma. Consequently, we diagnosed the patient as having rectal carcinoma and metastatic hepatic tumor with portal vein tumor thrombosis. We show that operating simultaneously on these conditions improved the prognosis for the patient. Moreover, the elevated tumor markers in the patient decreased dramatically 4 months after the surgery. The patient had no recurrence and was treated with continued adjuvant chemotherapy. This is the first successful case reported of concomitant surgery of abdominoperineal resection and right hepatic lobectomy with thrombectomy.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Successful Concomitant Surgery for Abdominoperineal Resection and Right Hepatic Lobectomy with Thrombectomy

Fukino

Oida

Kida

et al. 2011

Nichidai Igaku Zasshi

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show abstract

“…In the histopathological evaluation of hepatic metastasis, the following patterns of local invasion from the metastatic liver tumor have been reported; these types of invasion could affect prognosis or hepatic recurrence if unresected: intrahepatic portal vein invasion, 8,36,37,56,82,[143][144][145][146][147][148][149] hepatic vein invasion, 36,37,56,[143][144][145][146][147][148]150 intrahepatic bile duct invasion, 36,37,[143][144][145]147,148,151,152 perineural invasion, 101,143,146 satellite lesions, 5,6,20,54,55,100,102,103,144,145,153,154 invasion to adjacent organs, 8,36,37 and nodal metastasis to the hepatoduodenal ligament. 6,…”

Section: Patterns Of Local Invasion That May Provide Criteria For Thementioning

confidence: 99%

Surgical treatment for metastatic malignancies. Anatomical resection of liver metastasis: indications and outcomes

Yasui

Shimizu

2004

Int J Clin Oncol

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Hepatectomy may be the only treatment modality for the cure of colorectal liver metastasis. However, whether to perform nonanatomical resection or anatomical resection remains unclear. Original articles in English on liver metastasis, including reports that dealt with case series of more than 50 curative hepatectomies, were reviewed, and the current status of surgical treatment for colorectal liver metastasis was summarized, with a special emphasis on the relevance, indications, and outcomes of anatomical hepatectomy. Anatomical hepatic resection was performed in 63% of the patients. For patients who were treated by curative hepatectomy, including both anatomical and nonanatomical resection, the morbidity rates, mortality rates, 5-year survival rates, and rates of hepatic recurrence were 23%, 3.3%, 34%, and 41.2%, respectively. In 73 articles that each analyzed more than 50 patients treated with potentially curative hepatectomy, the incidence of anatomical resection exceeded 50% in 56 series, while anatomical resection was performed in fewer than 50% of the patients in 17 series. A comparison between these two groups naturally revealed a remarkable difference in the incidence of anatomical resection (72% versus 34%), but no difference in terms of morbidity; mortality; survival rates at 3, 5, and 10 years; or rate of hepatic recurrence. The profile of liver metastasis related to prognosis was generally advantageous to patients treated with nonanatomical resection, and this may have nullified the survival advantage of anatomical hepatectomy over nonanatomical resection. Anatomical resection provides a higher probability of coresecting microscopic invasions that are predictable but undetectable, and can be recommended as a standard procedure for locally advanced metastatic liver cancer.

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“…Only one case of acinar cell carcinoma has been reported so far [15] (Table 1). Although tumor thrombosis in the portal venous system is rarely recognized in patients with malignant tumors except for HCC, in addition to these pancreatic tumors, a few exceptional malignancies such as gastric cancer [16][17][18][19][20][21][22][23][24], colorectal cancer [4,23,[25][26][27][28][29][30][31], gallbladder cancer [32], renal cancer [33], malignant lymphoma [34][35][36], and malignant melanoma [37] have been reported to develop portal tumor thrombus.…”

Section: Discussionmentioning

confidence: 99%

A case of acinar cell carcinoma of the pancreas that formed extensive tumor thrombus of the portal vein

Igarashi¹,

Shinozaki²,

Mukada

2008

Clin J Gastroenterol

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A 58-year-old man was admitted to our hospital because of anorexia and back pain. He had been previously diagnosed with chronic pancreatitis with blood thrombus of the splenic vein at another hospital. Abdominal ultrasonography and computed tomography revealed a large mass in the body and tail of the pancreas, which directly invaded the stomach and the spleen. Small nodular metastases in both lungs were also detected. Furthermore, tumor thrombus continuously involved the splenic and proximal superior mesenteric vein, main portal vein, and its right intrahepatic branch. A metastatic mass was disclosed in the adjacent liver. The specimens obtained from portal tumor thrombus were histologically compatible with acinar cell carcinoma. Portal tumor thrombus is a rare condition in pancreatic tumors; however, it seems to be important to differentiate tumor thrombus from blood thrombus of the portal vein in order to know the true clinical stage and provide a suitable treatment.

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Hepatic Resection for Colorectal Metastasis with Macroscopic Tumor Thrombus in the Portal Vein

Cited by 32 publications

References 14 publications

Successful Concomitant Surgery for Abdominoperineal Resection and Right Hepatic Lobectomy with Thrombectomy

Successful Concomitant Surgery for Abdominoperineal Resection and Right Hepatic Lobectomy with Thrombectomy

Surgical treatment for metastatic malignancies. Anatomical resection of liver metastasis: indications and outcomes

A case of acinar cell carcinoma of the pancreas that formed extensive tumor thrombus of the portal vein

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