title: The impact of caudate lobe involvement after hepatic resection for colorectal metastases.
abstract: BACKGROUND
  Hepatic resections involving the caudate lobe are technically challenging with results from some centers indicating inferior outcomes. We assessed outcomes following hepatic resection for colorectal metastases involving the caudate lobe in a tertiary care center.
  
  
  METHODS
  Operative and oncological data from a prospectively maintained database were analyzed on 687 patients undergoing hepatic resection for colorectal metastases between 1993 and 2006. Patients were analyzed as those with caudate lobe metastases (CLM) and compared with those without caudate lobe involvement (NCLM).
  
  
  RESULTS
  Fifty-two of 687 patients had metastases involving the caudate lobe (8%). Patients with caudate lobe involvement were more likely to require an extended hepatic resection (75% vs 27%, P=0.001), perioperative blood transfusion (29% vs 14%, P=0.002), have a positive resection margin (57% vs 32%, P=0.001) and stay longer in hospital (12 vs 8 days, P=0.001). There was no difference in the complication rates (37% vs 29%) or 30-day mortality between the two groups (2% vs 1%). The median disease free (20 months vs 21 months), and cancer specific survival (42 months vs 59 months) were also similar in the CLM and NCLM groups.
  
  
  CONCLUSIONS
  Although caudate lobe involvement adds to the technical complexity of hepatic resection, these patients can be offered long term survival, similar to other patients with hepatic metastases from colorectal cancer.
authors.affiliation: Department of Hepatobiliary and Transplantation Surgery, St James University Hospital, Beckett Street, Leeds, LS9 7TF, UK.
authors.forename: A Z
authors.initials: AZ
authors.lastname: Khan
authors.forename: V K
authors.initials: VK
authors.lastname: Wong
authors.forename: H Z
authors.initials: HZ
authors.lastname: Malik
authors.forename: G Morris
authors.initials: GM
authors.lastname: Stiff
authors.forename: K R
authors.initials: KR
authors.lastname: Prasad
authors.forename: J P A
authors.initials: JP
authors.lastname: Lodge
authors.forename: G J
authors.initials: GJ
authors.lastname: Toogood
mesh_terms: D001803:Blood Transfusion / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome