Resection of liver metastases from colorectal cancer

Pedersen, Ib Krogh; Burcharth, F; Roikjær, O; Baden, H

doi:10.1007/bf02049807

Cited by 90 publications

(41 citation statements)

References 14 publications

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“…We should not operate on patients with hepatic lymph node metastasis. Although many researchers 2,9,14,[30][31][32][33][34] have noted that primary colorectal cancer affects the prognosis of patients who received hepatectomy for liver metastases, some 7,13,20,24,[35][36][37][38][39][40] have reported contrary results. This discrepancy may be due to rates of synchronous and metachronous metastasis in each study.…”

Section: Commentmentioning

confidence: 91%

Simplified Staging System for Predicting the Prognosis of Patients With Resectable Liver Metastasis

Minagawa

Yamamoto²,

Kosuge³

et al. 2007

Arch Surg

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Section: Commentmentioning

confidence: 91%

Simplified Staging System for Predicting the Prognosis of Patients With Resectable Liver Metastasis

Minagawa

Yamamoto²,

Kosuge³

et al. 2007

Arch Surg

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“…Os cânceres localizados no cólon ascendente (35casos), ângulo hepático (17 casos Exame proctológico É unânime a afirmativa de que o exame proctológico deve ser integrante do exame clínico na abordagem propedêutica dos pacientes com sintomas anorretocolônicos, independentemente de haver suspeitas ou não de tumor 1,2,4,5,9,11,15,22,25,30,38,41,43,47,50,52 . Dos 490 pacientes portadores de câncer colônico de nossa casuística, 476 tiveram o diagnóstico do tumor colônico feito preoperatoriamente (97,1%), quer pelo exame proctológico (tumores localizados à altura do alcance retossigmoidoscópico), quer pelo enema opaco (início da série, por não disponibilidade da colonoscopia) ou pela colonoscopia, ficando, os demais exames, responsáveis pelo diagnóstico da evolução ou estadiamento das neoplasias.…”

Section: Tumores De Cólon Ascendente âNgulo Hepático Cólon Transverunclassified

Câncer colônico - epidemiologia, diagnóstico, estadiamento e gradação tumoral de 490 pacientes

Cruz¹,

Santana²,

Santana³

et al. 2007

Rev bras. colo-proctol.

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RESUMO: O objetivo deste trabalho é estudar 490 pacientes portadores de câncer colônico, analisando incidência absoluta e topográfica do câncer nos cólons; distribuição por décadas etárias e sexos dos pacientes; sintomatologia; gradação e estadiamento por exame proctológico, exames de imagens, achados cirúrgicos e exame histopatológicos de biópsias e peças cirúrgicas; distribuição por topografias e gradação tumoral; concomitância e contemporaneidade de pólipos; modalidades de pólipos e poliposes colorretais concomitantes e contemporâneos;

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“…Multiple prognostic parameters after resection of liver metastases have been suggested-for example, number of liver metastases, size of liver metastases, presence of hepatic vein invasion, width of resection margin, disease-free Detection of Disseminated Tumor Cells interval after the primary tumor, stage of the primary tumor, and grading of liver metastases. 5,12,[32][33][34][35][36] Most of those parameters, however, could not be confirmed in other studies or merely predict intrahepatic tumor recurrence. No marker is currently available that can predict extrahepatic tumor recurrence after potentially curative resection.…”

Section: Detection Of Hematogenic Tumor Cell Disseminationmentioning

confidence: 99%

Detection of Hematogenic Tumor Cell Dissemination in Patients Undergoing Resection of Liver Metastases of Colorectal Cancer

Weitz¹,

Koch²,

Kienle³

et al. 2000

Annals of Surgery

118

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ObjectiveTo determine the extent of pre-and intraoperative hematogenic tumor cell dissemination in patients undergoing liver resection for metastatic colorectal cancer. Summary Background DataFor patients with hepatic metastases of colorectal cancer, liver resection is the only potentially curative therapy. However, 38% to 53% of patients develop extrahepatic tumor recurrence, probably caused by tumor cells disseminated before or during surgery not detected by current staging systems. MethodsBlood samples harvested before, during, and after surgery from 41 patients and bone marrow samples from 30 patients undergoing resection of liver metastases of colorectal cancer were analyzed for disseminated tumor cells using cytokeratin 20 reverse transcriptase-polymerase chain reaction. ResultsTumor cells were detected in the blood samples of 26 of the 41 patients (63.4%) and in the bone marrow samples of 8 of the 30 patients (26.7%). Tumor cells were detected significantly more often during surgery than before or after surgery. Intraoperative tumor cell dissemination was detected in 41.7% of patients undergoing resection of two or more liver segments but only 14.3% of patients undergoing resection of one liver segment. Compared with resection of primary colorectal cancer, major liver resection carries an increased risk for intraoperative tumor cell dissemination. ConclusionsDetection of disseminated tumor cells in patients undergoing liver resection for metastases of colorectal cancer using cytokeratin 20 reverse transcriptase-polymerase chain reaction might help to identify patients at high risk for tumor recurrence who may benefit from adjuvant therapy. Major liver resection of metastases leads to frequent intraoperative tumor cell shedding, possibly preventable by alternative surgical strategies.The liver is the most common site for metastatic spread of colorectal cancer as a result of the portal venous drainage of the gastrointestinal tract. The frequency of synchronous liver metastases ranges from 15% to 30%, and a similar percentage of patients develop metachronous liver metastases.1-4 For these patients, hepatic resection is the only treatment option offering a reasonable chance of long-term survival. 5,6 Patients with potentially resectable but untreated liver metastases have a 3-year survival rate of 20%, and fewer than 3% of patients survive 5 years.7 Liver resection of metastases of colorectal cancer results in a 3-year survival rate of 30% to 61% and a 5-year survival rate of 16% to 51%, depending on patient selection. 8 -12 However, after resection of liver metastases, 38% to 53% of resected patients develop extrahepatic tumor recurrence, probably caused by the release of neoplastic cells into the systemic circulation either before or during hepatic resection. 8,9,[13][14][15] It has always been suspected, but never proven, that mechanical alteration of the liver during resection of liver metastases leads to massive intraoperative tumor cell shedding into the circulation. Detection of this intraoperative tu...

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Resection of liver metastases from colorectal cancer

Cited by 90 publications

References 14 publications

Simplified Staging System for Predicting the Prognosis of Patients With Resectable Liver Metastasis

Simplified Staging System for Predicting the Prognosis of Patients With Resectable Liver Metastasis

Câncer colônico - epidemiologia, diagnóstico, estadiamento e gradação tumoral de 490 pacientes

Detection of Hematogenic Tumor Cell Dissemination in Patients Undergoing Resection of Liver Metastases of Colorectal Cancer

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