title: Hepatic resection for colorectal metastasis with macroscopic tumor thrombus in the portal vein.
abstract: Metastatic lesions in the liver derived from colorectal cancer rarely invade the portal vein macroscopically. Little is known about the clinical characteristics and outcome of surgical treatment in patients with tumor thrombus in the portal vein. Medical charts of 142 consecutive patients who underwent hepatic resection for colorectal metastasis were reviewed retrospectively. Of the 142 patients, 4 (2.8%) had macroscopic portal vein invasion. The most prominent characteristic on preoperative imaging was segmental staining in the arterial phase shown by dynamic computed tomography (CT) or by CT arteriography. This finding was positive in all four of the patients. All patients underwent anatomic liver resection and were alive with no evidence of disease for an average of 52.3 months (range 21-102 months). Macroscopic tumor thrombus in the portal vein is rare with colorectal metastasis. It is accurately detected by CT by checking for signs of segmental staining. In this setting, anatomic major resection of the liver is essential for curative treatment.
authors.affiliation: Department of Surgery, Cancer Institute Hospital, 1-37-1 Kami-ikebukuro, 70-8455, Toshima-ku, Tokyo, Japan.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Tada
authors.forename: Norihiro
authors.initials: N
authors.lastname: Kokudo
authors.forename: Makoto
authors.initials: M
authors.lastname: Seki
authors.forename: Masashi
authors.initials: M
authors.lastname: Ueno
authors.forename: Kaoru
authors.initials: K
authors.lastname: Azekura
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Ohta
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Toshiki
authors.initials: T
authors.lastname: Matusbara
authors.forename: Takashi
authors.initials: T
authors.lastname: Takahashi
authors.forename: Toshifusa
authors.initials: T
authors.lastname: Nakajima
authors.forename: Akio
authors.initials: A
authors.lastname: Yanagisawa
authors.forename: Tetsuichiro
authors.initials: T
authors.lastname: Muto
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D003110:Colonic Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000473:pathology*; D012004:Rectal Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed