Major hepatic resection reduces the probability of intrahepatic recurrences following resection of colorectal carcinoma liver metastases.
OBJECTIVE
The use of major versus limited hepatic resection for colorectal carcinoma liver metastases remains controversial. We evaluated the role of major hepatic resection in managing patients with colorectal carcinoma liver metastases.


METHODS
We performed a retrospective analysis of 102 patients undergoing either major (n = 61) or limited (n = 41) hepatic resection for colorectal carcinoma metastases. Major hepatic resection was defined as segmentectomy or more extensive hepatic resection; limited hepatic resection was defined as non-anatomic removal of the liver tumor plus a rim of normal parenchyma. The median follow-up period was 94 months.


RESULTS
Patients undergoing major hepatic resection had larger hepatic tumors than those undergoing limited hepatic resection (p < 0.001, Fisher's exact test). The cumulative probability of intrahepatic recurrences after major hepatic resection was significantly lower than that after limited hepatic resection (p = 0.010, log-rank test). Major hepatic resection independently reduced the probability of intrahepatic recurrences (p = 0.043, Cox's proportional hazards model). Limited hepatic resection frequently resulted in recurrences within the same segment or the same lobe of the remnant liver.


CONCLUSIONS
Major hepatic resection is more effective in reducing the risk of intrahepatic recurrences than limited hepatic resection in patients with resectable colorectal carcinoma liver metastases.
Nagakura
Shigenori
S
Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata City, 951-8510 Japan.
Shirai
Yoshio
Y
Yokoyama
Naoyuki
N
Wakai
Toshifumi
T
Suda
Takeyasu
T
Hatakeyama
Katsuyoshi
K
D000230:Adenocarcinoma / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology*; D009367:Neoplasm Staging; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000209:etiology*; D011336:Probability; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies