Is surgical resection justified for stage IV colorectal cancer patients having bilobar hepatic metastases?--an analysis of survival of 77 patients undergoing hepatectomy.
BACKGROUND
Surgical indication for stage IV colorectal cancer patients with bilobar hepatic metastases may be controversial.


METHODS
Retrospective cohort analysis was performed using data of 200 patients who underwent surgical resections for synchronous metastases of colorectal cancer between 1990 and 2005. Of these, 80 patients had solitary, 43 had unilobar multiple, and 77 had bilobar metastases. Prognostic factors of the 77 bilobar metastases were evaluated using multivariate analysis. The survival was compared with that of 95 patients undergoing chemotherapy for unresectable bilobar hepatic metastases.


RESULTS
Univariate and multivariate analyses revealed that the number of metastasis (≥6) [relative risk (RR), 2.7; P = 0.002] and depth of invasion (T4) (RR, 2.0; P = 0.04) were predictors of survival of the 77 patients. The survival of 11 T4 cancer patients with six or more metastases was poor, but significantly better than that of 95 patients with unresectable bilobar metastases (P = 0.04).


CONCLUSIONS
Surgical resection in stage IV colorectal cancer patients having bilobar hepatic metastases was justified in the present setting.
Sakamoto
Yoshihiro
Y
Hepatobiliary and Pancreatic Surgery Division, National Cancer Center Hospital, Tokyo, Japan. yosakamo@ncc.go.jp
Fujita
Shin
S
Akasu
Takayuki
T
Nara
Satoshi
S
Esaki
Minoru
M
Shimada
Kazuaki
K
Yamamoto
Seiichiro
S
Moriya
Yoshihiro
Y
Kosuge
Tomoo
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality* / Q000556:secondary / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome