Does repeated surgery improve the prognosis of colorectal liver metastases?
Hepatic resection for colorectal metastases was performed for 188 patients. Overall survival rates after the first hepatectomy are 41.4% and 32.7% for 5 and 10 years, respectively. The survival rate of 116 cases with unilobar hepatic metastases (H1) is significantly higher than those of 48 cases with two to four bilobar metastases (H2) and 24 cases with more than four (H3), respectively. However, the differences between the survival rates from H1 with multiple metastases, H2, and H3 are not significant, even though the H3 group has no 10-year survivors. The 5-year survival rates after the second hepatectomy (30 patients) and the resection of the lung (26 patients) are 30.3% and 35.2%, respectively, in this series. In those patients, the 5-year survival rates from the first metastasectomy are 43.4% and 50.3%, respectively. There are 14 5-year survivors with multiple metastases and 8 of those patients underwent multiple surgeries. There are 13 patients with three or more repeat resections of the liver and/or lung. The 5-year survival rates of the patients from the first and third metastasectomy are 53.9% and 22.5%, respectively. Repeat operations for the liver and the lung contribute to the improving prognosis.
Morise
Zenichi
Z
Department of Surgery and Thoracic Surgery, Fujita Health University School of Medicine, Toyoake, Japan. zmorise@aol.com
Sugioka
Atsushi
A
Fujita
Junko
J
Hoshimoto
Sojun
S
Kato
Takazumi
T
Hasumi
Akitake
A
Suda
Takashi
T
Negi
Hiromichi
H
Hattori
Yoshinobu
Y
Sato
Harunobu
H
Maeda
Kotaro
K
D003110:Colonic Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery; D008175:Lung Neoplasms / Q000556:secondary / Q000601:surgery; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011379:Prognosis; D012004:Rectal Neoplasms / Q000473:pathology*; D012086:Reoperation; D015996:Survival Rate