[Another failure in the attempt of definition of the indications to the resection of liver metastases of colorectal origin].
Many discordances can be found in the literature of the last ten years, about the definition of the main prognostic factors after resection of LM from colorectal cancers. Indications of liver resections depend on these prognostic factors. We prospectively enregistred the parameters of 97 patients which had undergone 119 hepatectomies from 1983 to 1990, and we have done a prognostic study. The mean number of resected LM was 2.3, nineteen patients had at least four LM, 22 patients had extrahepatic localization, and 16 had a 0-1 mm free margin. Only one patient died during the postoperative course. The overall five years survival was 33 +/- 8% and the disease free survival was 26 +/- 7%. Unfortunately none prognostic factor significantly influenced the survey in this series, and notably nor the staging of the primitive tumor, nor the synchronous or metachronous happening, nor the number of LM, nor the extrahepatic localizations, nor the free margin. We conclude that: 1) a greater number of patients and a more important follow-up could permit to define clinical or paraclinical prognosis factors but they will be only secondary prognosis factors; 2) it is necessary to prospectively study some new biologic, histologic and immunologic parameters in order to discover the fundamental prognosis factors.
Elias
D
D
Service de Chirurgie Digestive Carcinologique, Institut Gustave-Roussy, Villejuif.
Lasser
P
P
Rougier
P
P
Debaene
B
B
D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality* / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D011379:Prognosis
Nouvel échec dans la tentative de définition des indications d'exérèse des métastases hépatiques d'origine colo-rectale.