Resection of Concomitant Hepatic and Extrahepatic Metastases from Colorectal Cancer - A Worthwhile Operation?
| Autor: | Andrei Diaconescu, Florin Botea, Radu Dumitru, Silviu Ciurea, Mihnea Ionescu, Mugur Grasu, Dana Tomescu, Sorin Alexandrescu, Zenaida Ionel, Cristian Zlate, Razvan Grigorie, Catalin Vasilescu, Vlad Herlea, Irinel Popescu, Doina Hrehoret, Adina Croitoru, Vladislav Brasoveanu, Gabriela Droc, Mihai Toma, Mirela Boros |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Lung Neoplasms Colorectal cancer medicine.medical_treatment Ovariectomy Ovary Gastroenterology Disease-Free Survival 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Hepatectomy Humans Pneumonectomy Colectomy Peritoneal Neoplasms Neoplasm Staging Retrospective Studies Ovarian Neoplasms Univariate analysis Lung business.industry Romania Liver Neoplasms medicine.disease Colorectal surgery Survival Rate Lymphatic system medicine.anatomical_structure Treatment Outcome 030220 oncology & carcinogenesis Concomitant 030211 gastroenterology & hepatology Surgery Female business Colorectal Neoplasms Follow-Up Studies |
| Zdroj: | Chirurgia (Bucharest, Romania : 1990). 112(6) |
| ISSN: | 1221-9118 |
| Popis: | Background: The benefit of hepatic resection in case of concomitant colorectal hepatic and extrahepatic metastases (CHEHMs) is still debatable. The purpose of this study is to assess the results of resection of hepatic and extrahepatic metastases in patients with CHEHMs in a high-volume center for both hepatobiliary and colorectal surgery and to identify prognostic factors that correlate with longer survival in these patients. Method It was performed a retrospective analysis of 678 consecutive patients with liver resection for colorectal cancer metastases operated in a single Centre between April 1996 and March 2016. Among these, 73 patients presented CHEHMs. Univariate analysis was performed to identify the risk factors for overall survival (OS) in these patients. Results: There were 20 CHMs located at the lymphatic node level, 20 at the peritoneal level, 12 at the ovary and lung level, 12 presenting as local relapses and 9 other sites. 53 curative resections (R0) were performed. The difference in overall survival between the CHEHMs group and the CHMs group is statistically significant for the entire groups (p 0.0001), as well as in patients who underwent R0 resection (p 0.0001). In CHEHMs group, the OS was statistically significant higher in patients who underwent R0 resection vs. those with R1/R2 resection (p=0.004). Three variables were identified as prognostic factors for poor OS following univariate analysis: 4 or more hepatic metastases, major hepatectomy and the performance of operation during first period of the study (1996 - 2004). There was a tendency toward better OS in patients with ovarian or pulmonary location of extrahepatic disease, although the difference was not statistically significant. Conclusion In patients with concomitant hepatic and extrahepatic metastases, complete resection of metastatic burden significantly prolong survival. The patients with up to 4 liver metastases, resectable by minor hepatectomy benefit the most from this aggressive onco-surgical management. |
| Databáze: | OpenAIRE |
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