title: [Surgical management for more than 10 liver metastases from colorectal cancer].
abstract: We examined the clinical course of patients with multiple liver metastases (≥10) from colorectal cancer after hepatectomy. Of 455 patients, 336 patients had 1-4 metastases, 71 had 5-9 metastases, and 48 had ≥10 metastases (31 patients had undergone chemotherapy along with hepatectomy and 17 had not undergone chemotherapy). Chemotherapy was effective in improving the 5-year survival rate of patients with 5 or more metastases. The 5-year survival rate in patients who underwent hepatectomy along with chemotherapy (52.7%[1-4 metastases], 49.9%[5-9 metastases], and 42.3% [≥10; n=5]) was better than that in patients who did not undergo chemotherapy( 56.1%[not significant: ns], 13.1% [p=0.0003], and 0%[p<0.0001], respectively). Five patients with ≥10 liver metastases survived for 5 years after hepatectomy, of which, 1 received FOLFOX (Leucovorin plus 5-FU plus oxaliplatin) adjuvant chemotherapy, 2 received preoperative FOLFOX, and 2 received LV5FU2 (5-FU plus Leucovorin) hepatic arterial infusion chemotherapy. Our results suggest that long-term improvement in prognosis could be possible with aggressive repeat hepatectomy along with effective chemotherapy.
authors.affiliation: Dept. of Gastroenterological Surgery, Saitama Cancer Center.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Amikura
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Sakamoto
authors.forename: Toshiro
authors.initials: T
authors.lastname: Ogura
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Yatsuoka
authors.forename: Yoji
authors.initials: Y
authors.lastname: Nishimura
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kawashima
authors.forename: Takashi
authors.initials: T
authors.lastname: Fukuda
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Ehara
authors.forename: Daiji
authors.initials: D
authors.lastname: Oka
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Kensei
authors.initials: K
authors.lastname: Yamaguchi
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome