title: Resection margin with anatomic or nonanatomic hepatectomy for liver metastasis from colorectal cancer.
abstract: BACKGROUND
  When hepatectomy is used as a primary treatment for liver metastasis from colorectal cancer (CRCLM), the balance between surgical curability and functional preservation of the remnant liver is of great importance.
  
  
  METHODS
  A total of 108 patients who underwent initial hepatectomy for CRCLM were retrospectively analyzed with respect to tumor extent, operative method, and prognosis, including recurrence.
  
  
  RESULTS
  The 1-, 2-, 3-, and 5-year overall survival rates (OS) for all patients were 90.5%, 77.8%, 63.2%, and 51.6%, respectively. Multivariate analysis indicated serum carbohydrate antigen 19-9 (CA 19-9) level after hepatectomy (<36 or ≥36 mAU/mL) and presence of recurrence as independent prognostic factors of OS (P = 0.0458 and 0.0249, respectively), and tumor depth of colorectal cancer (<se (a2) vs. ≥se (a2)) and serum CA 19-9 level after hepatectomy as the significant factors affecting disease-free survival (DFS) (P = 0.0025 and 0.00138, respectively). Neither resection margin nor type of hepatectomy (anatomic or nonanatomic) for CRCLM was a significant prognostic factor for OS or DFS or CRCLM recurrence, including intrahepatic recurrence.
  
  
  CONCLUSIONS
  In CRCLM, we believe that nonanatomic hepatectomy with narrow margin is indicated, and optimal treatment would include functional preservation of as much of the remnant liver as possible.
authors.affiliation: Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan. sur129@poh.osaka-med.ac.jp
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Inoue
authors.forename: Michihiro
authors.initials: M
authors.lastname: Hayashi
authors.forename: Koji
authors.initials: K
authors.lastname: Komeda
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Masubuchi
authors.forename: Masashi
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Hidenori
authors.initials: H
authors.lastname: Yamana
authors.forename: Hajime
authors.initials: H
authors.lastname: Kayano
authors.forename: Tetsunosuke
authors.initials: T
authors.lastname: Shimizu
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Asakuma
authors.forename: Fumitoshi
authors.initials: F
authors.lastname: Hirokawa
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Miyamoto
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takeshita
authors.forename: Yuro
authors.initials: Y
authors.lastname: Shibayama
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Uchiyama
mesh_terms: D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends