[Recurrent tumor after R0 resection of colorectal liver metastases. Incidence, resectability and prognosis].
In the period 1960 to 1992 a total of 366 patients underwent macroscopic and histologic complete resection (R0) of colorectal liver metastases. Excluding 16 operative deaths and 4 patients with incomplete follow-up information, 346 patients form the basis for this report. Of them, 240 (69.4%) developed recurrent disease involving the liver in 136 (39.3%) instances. 71 patients underwent a tumor related reoperation with a re-resection performed in 60 cases. This involved the liver in 22 patients. 47 of these procedures (19.6% of all recurrences), and 16 re-resections of the liver (11.8% of hepatic recurrences) were ultimately classified R0. Additional 9 patients who had the initial liver resection performed in other hospitals underwent hepatic re-resection which was classified R0 in 8. Out of 8 subsequent reoperations, 3 addressed the liver. Operative mortality in the 34 re-resections at the liver was 2.9% while nonlethal morbidity was 17.7%. After a minimum and median follow-up time of 18 and 49 months, resp., 27 patients are alive without recurrent disease, including 11 patients with hepatic re-resection. Another 4 patients are alive with disease, one of them after repeat liver resection. 5-year survival from re-resection is 39.0% for the entire group of 55 R0-patients, and 45.6% for the 24 who underwent hepatic R0-re-resection.(ABSTRACT TRUNCATED AT 250 WORDS)
Klinik und Poliklinik für Chirurgie-Abteilung Allgemeine und Viszerale Chirurgie, Friedrich-Schiller-Universität Jena.
J
J
Scheele
R
R
Stangl
K
K
Schmidt
A
A
Altendorf-Hofmann
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D010166:Palliative Care; D012086:Reoperation; D015996:Survival Rate
Das Tumorrezidiv nach R0-Resektion colorectaler Lebermetastasen. Häufigkeit, Resektabilität und Prognose.