Resection of synchronous liver metastases from colorectal cancer.
BACKGROUND
The prognosis for patients with liver metastases from colorectal cancer is still poor. Thus, patient selection for hepatic resection is essential to improve the poor results of the procedure. Some reports have shown that the prognosis for patients with synchronous liver metastases is worse than that for those with metachronous liver metastases. Therefore, determination of the factors that influence outcome after resection of synchronous liver metastases is more important than with metachronous liver metastasis.


METHODS
We studied patients who had been followed for more than 5 years after undergoing resection of synchronous liver metastases from colorectal cancer.


RESULTS
Among the 12 prognostic factors studied (age, gender, adjuvant chemotherapy, tumor site, CEA level, tumor differentiation, tumor size, regional lymph node metastatic status, distribution of liver metastases, number of liver metastases, tumor size and pathological margin), regional lymph node metastatic status and pathological margin were significant prognostic factors by univariate analysis (p = 0.0002 and 0.005, respectively). Regional lymph node metastatic status was a significant prognostic factor by multivariate analysis (p = 0.031). The survival curve of patients with six or more regional lymph node metastases was similar to that of patients with non-resectable liver metastasis.


CONCLUSIONS
The resection of synchronous liver metastases in patients with six or more regional lymph node metastases is relatively contraindicated. For these patients, other treatment modalities should be considered.
Fujita
S
S
Department of Surgery, National Cancer Center Hospital, Tokyo, Japan. sfujita@gan2.ncc.go.jp
Akasu
T
T
Moriya
Y
Y
D000367:Age Factors; D000704:Analysis of Variance; D002272:Carcinoembryonic Antigen / Q000032:analysis; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000473:pathology* / Q000601:surgery; D000075202:Contraindications; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000009:adverse effects; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D018579:Patient Selection; D011379:Prognosis; D016016:Proportional Hazards Models; D012004:Rectal Neoplasms / Q000473:pathology* / Q000601:surgery; D012737:Sex Factors; D015996:Survival Rate; D016896:Treatment Outcome
D002272:Carcinoembryonic Antigen