title: Surgical Indications for Multiple and Synchronous Liver Metastases from Colorectal Cancer.
abstract: Surgical indications for resection of synchronous metastasis from colorectal cancer (CRC) are still controversial. 57 patients with synchronous and multiple metastatic liver tumors were studied. 1) The three-year survival rate and MST for synchronous metastasis, 55% and 28.4 ± 15.4 months, were clearly poorer than those of the patients with metachronous, 100% and 39.9 ± 10.8 months. 2) Three-year survival rate and MST for a single tumor were similar to those for multiple tumors but were 83% and 36.6 ± 14.0 months in patients with ≤ 2 tumors, significantly better (p = 0.0127) than those in patients with 3 tumors, 65% and 24.0 ± 13.6 months. 3) In the patients with synchronous liver tumors, 3-year survival rate and MST after staged hepatectomy were significantly better, 82% and 34.5 ± 14.9 months (p = 0.0467), than simultaneous hepatectomy, 29% and 23.9 ± 13.6 months. 4) In patients with repeat hepatectomy, the only difference between first vs. repeat hepatectomy was in tumor number detected, 4.4 ± 1.2 vs. 1.2 ± 0.1. The present data show that neoadjuvant chemotherapy might improve patient prognosis, and with 3 tumors, planning of staged hepatectomy is best, even if technically removed.
authors.forename: Shinji
authors.initials: S
authors.lastname: Osada
authors.forename: Hisashi
authors.initials: H
authors.lastname: Imai
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Sasaki
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Naoki
authors.initials: N
authors.lastname: Okumura
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nonaka
authors.forename: Takao
authors.initials: T
authors.lastname: Takahashi
authors.forename: Kazuya
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yoshida
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D012086:Reoperation; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden