Complete remission of disease for 5 years following initial and repeat resection of the liver for the removal of 22 metastases of colorectal origin.
Although liver resection is accepted as the only available treatment that regularly produces long-term survival with possible cure in patients with colorectal carcinoma metastatic to the liver, controversy appears to exist regarding the surgical indication for patients with more than four nodules. Similarly, it may be arguable to perform a repeated hepatic resection for a patient who developed multiple recurrent liver metastases with a short disease-free period after the initial liver resection. During the last 7 years, we have adopted constantly the aggressive surgical approach to patients with colorectal carcinoma metastatic to the liver if the number of tumor nodules identified preoperatively were less than ten and irrespective of the length of disease-free period after the previous resection. Here we report on a patient who underwent hepatic resection twice at an interval of 3 months and in whom a total of 22 metastatic nodules (6 in the initial hepatic resection and 22 in the repeated resection) were removed. The patient is now alive and remains disease-free, 5 years after the first liver resection.
Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Hiroshi
H
Imamura
Keiji
K
Sano
Yasushi
Y
Harihara
Tamaki
T
Noie
Kiyoshi
K
Hasegawa
Masami
M
Minagawa
Tadatoshi
T
Takayama
Masatoshi
M
Makuuchi
D003082:Colectomy / Q000379:methods; D003110:Colonic Neoplasms / Q000473:pathology* / Q000601:surgery; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012086:Reoperation; D016896:Treatment Outcome