Role of node dissection for lymphatic remetastasis in repeat hepatectomy for colorectal liver metastasis.
BACKGROUND
Although the prognosis after hepatectomy for colorectal liver metastasis with hilar node remetastasis is poor, the role of node dissection for lymphatic remetastasis at repeat hepatectomy for hepatic recurrence is unknown.


METHODS
Fifty patients who underwent node dissection plus hepatectomy were retrospectively reviewed and divided into three groups: group I, 38 patients with a negative node; group II, 6 with a positive node at initial hepatectomy, and group III, 6 with a positive node at repeat hepatectomy.


RESULTS
The 5-year survival rate after initial hepatectomy in group I was 46%. All patients in group II died within 2 years after surgery. In group III, the median survival time was 42 months after repeat hepatectomy, and 4 patients survived for more than 5 years after initial hepatectomy. Disease-free time was more than 1 year after initial hepatectomy in all long-term survivors. In addition, node metastasis was limited around the hepatic pedicle and postpancreatic area in 3 of 4 long-term survivors.


CONCLUSIONS
Node dissection for lymphatic remetastasis may contribute to longer survival only when node metastasis is limited around the hepatic pedicle and postpancreatic area at repeat hepatectomy performed more than 1 year after the initial hepatectomy.
Sakaguchi
Takanori
T
Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan. saka1119@hama-med.ac.jp
Suzuki
Shohachi
S
Nakamura
Satoshi
S
Konno
Hiroyuki
H
D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D011379:Prognosis; D015996:Survival Rate