Major anatomical hepatic resection with regional lymph node dissection for liver metastases from colorectal cancer

Abstract

Abstract:Sixty-four patients with liver metastases from colorectal cancer were studied to clarify the characteristics of the regional spread of liver metastases (secondary invasive factors) and the effects of major anatomical hepatic resection with lymph node dissection on reducing liver recurrence. No secondary invasive factors, i.e., lymph node metastasis, portal or hepatic vein involvement, bile duct involvement, micrometastasis, and direct invasion, were observed in patients with liver metastases less than 3 cm in diameter (5-year survival rate; 100%). Secondary invasive factors were seen in 19.2% of the patients with liver metastases from 3 cm to less than 6cm (5-year survival rate; 28.7%), and in 45.2% of those with liver metastases 6 cm and over (5-year survival rate; 14.6%). Secondary invasive factors were noted in 45% of the patients with recurrence in the remnant liver. Although 31% of all 64 patients exhibited secondary invasive factors, major anatomical hepatic resection with lymph node dissection achieved a low liver recurrence rate of 31.3%. In conclusion, considering the risks attributed to secondary invasive factors, major anatomical hepatic resection with lymph node dissection is an appropriate surgical procedure for patients with liver metastases exceeding 3 cm in diameter.

Treatment strategy for synchronous metastases of colorectal cancer: is hepatic resection after an observation interval appropriate?

“…In the present study, we analyzed the outcomes after hepatic resection for metastases of colorectal cancer at our hospital and investigated whether or not the policy of interval hepatic resection for synchronous liver metastases is reasonable. Since 1983, the main procedure at our hospital for hepatic resection of colorectal cancer metastases has been anatomical resection based on hemihepatectomy and lymph node dissection [1,9]. Our basic policy has been to wait for an interval of 3 months after resection of the primary lesion and then conduct hepatic resection for the synchronous hepatic metastases.…”

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

“…With further accumulation of data from several case series of colorectal liver metastases treated with surgery, the safety and efficacy of hepatectomy became widely accepted. More recently, hepatectomy has come to be considered and attempted even for patients with extrahepatic recurrences, [28][29][30][31][32][33] or hepatic node metastases 22,[34][35][36][37][38][39][40] to the hepatic hilum, which, in the past, had not been indicated for surgical resection. Such an aggressive approach, however, is not currently shared by all investigators.…”

“…The actual numbers of each type of surgery performed were assessed from 73 articles, [4][5][6][7][8][9][10][11][12][13]16,[19][20][21][22][34][35][36][37][38]41,[54][55][56] each of which described the outcome of curative treatment of more than 50 patients, and presented the proportions of anatomical resections among all hepatectomies performed (Table 1). Anatomical hepatic resection was performed in 63% of the patients (range, 16%-100%).…”

Clinicopathological significance of fibrotic capsule formation around liver metastasis from colorectal cancer

“…Radical hepatectomy for liver metastasis from colorectal cancer can provide patients with 5-year survival rates close to 40% (Scheele et al 1990;Sugihara et al 1993;Yasui et al 1995;Fong et al 1999). However, the long-term survival rate after hepatectomy is still far from satisfactory because of frequent recurrence in the remnant liver and distant organs.…”