Mesenteric lymph nodes status influencing survival and recurrence pattern after hepatectomy for colorectal liver metastases.
OBJECTIVE
We retrospectively reviewed our results with curative hepatic resection of metastases from colorectal carcinoma, and analyzed several factors of the primary tumor and liver metastases.


METHODS
From 1988 to 1995, 90 patients underwent curative resection of colorectal liver metastases. The total mortality rate was 1.1%. Overall 5-year survival rate after hepatectomy was 37.9%.


RESULTS
Mesenteric lymph node metastases from the primary tumor and the prehepatectomy serum carcinoembryonic antigen level were significant. In multivariate analysis, positive mesenteric lymph node was an independent prognostic factor. In the recurrent patterns, mesenteric lymph node metastases were associated with extrahepatic recurrence after hepatectomy.


CONCLUSIONS
The prehepatectomy carcinoembryonic antigen level and mesenteric lymph node metastases of the primary tumor were the most important predictive factors for long survival after hepatectomy. Patients with these risk factors should be closely followed up with regard not only to the remnant liver but also extrahepatic organs.
Yamada
Hidehisa
H
Department of Surgical Oncology, Division of Cancer Medicine, Hokkaido University Graduate School of Medicine, N15, W7, Kita-Ku, Sapporo, 060-8648, Japan. h-yamada@med.hokudai.ac.jp
Katoh
Hiroyuki
H
Kondo
Satoshi
S
Okushiba
Shunichi
S
Morikawa
Toshiaki
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy / Q000401:mortality; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality* / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008643:Mesentery; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology; D016016:Proportional Hazards Models; D012189:Retrospective Studies