Hepatectomy for liver metastasis of colorectal cancer.
OBJECTIVE
The objective of this study was to investigate whether hepatic resection (HR) can increase the survival of liver metastasis of colorectal cancer (CRC).


METHODS
CRC patients (n=669) with liver metastasis treated at the Zhongshan Hospital, Fudan University from 1/2000 to 7/2007 were included in the study to investigate the relationship between HR and cancer survival.


RESULTS
CRC patients (n=669) with liver metastases who had primary tumor resection were grouped in synchronous liver metastasis (SLM; 56.7%, n=379) and metachronous liver metastasis (MLM) groups (43.3%, n=290). Hepatic resection rates were lower (32.5%, n=123) in the SLM than the MLM group (44.8%, n=130, P<0.05). The 30-day mortality rate in the MLM (2.3%) was significantly lower than SLM (2.4%) groups. The 5-year survival rates (36.6%) was same compared to SLM group (33.1%, P>0.05). One-, 2-, and 3-year survival of stages I and II operation cases were 92.5% vs 86.5%, 0.7% vs 58.0%, and 42.1% vs 44.9% (P>0.05) in the SLM group, respectively. Recurrence after first hepatic resection associated with a 2.23-fold increased risk of death (P<0.01). Incision margins larger than 1 cm and HR for recurrence associated with 34% and 27% (P<0.05) decreased death risk.


CONCLUSIONS
Hepatic resection could help the survival of liver metastasis of colorectal cancer, and stage I surgery is safe for this disease.
Xu
Jianmin
J
Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, People's Republic of China. xujmin@yahoo.com.cn
Wei
Ye
Y
Zhong
Yunshi
Y
Fan
Jia
J
Zhou
Jian
J
Qin
Lunxiu
L
Ren
Li
L
Qin
Xinyu
X
D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors