title: [Perioperative Steroid Administration for Colorectal Cancer with Synchronous Unresectable Hepatic Metastases].
abstract: OBJECTIVE
  In our institution, steroids are administered before resection of primary colorectal cancer lesions with synchronous unresectable hepatic metastases in order to avoid severe postoperative complications and hepatic failure. We herein report the results of the treatment.
  
  
  METHODS
  Thirty-eight colorectal cancer patients with synchronous unresectable hepatic metastases were divided into 2 groups: Group S (patients who received steroids in the perioperative period) and Group N (other patients). The clinicopathological features, post-operative course, and survival were compared between the 2 groups. Hydrocortisone sodium succinate was administered twice a day from immediately before laparotomy until the second postoperative day.
  
  
  RESULTS
  The number of patients with severe hepatic metastases and extra-hepatic metastases was significantly higher in Group S. No significant differences were observed between the 2 groups regarding the incidence of severe postoperative complications or the overall survival. Among 25 patients with liver dysfunction, the complication rate was significantly lower and survival was significantly longer in Group S compared to Group N.
  
  
  CONCLUSIONS
  The perioperative administration of steroids to colorectal cancer patients with synchronous unresectable hepatic metastases may reduce the complication rate and may thus improve survival, especially in patients with liver dysfunction.
authors.affiliation: Dept. of Frontier Surgery, Graduate School of Medicine, Chiba University.
authors.forename: Gaku
authors.initials: G
authors.lastname: Ohira
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyauchi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Narushima
authors.forename: Akiko
authors.initials: A
authors.lastname: Kagaya
authors.forename: Yorihiko
authors.initials: Y
authors.lastname: Muto
authors.forename: Hiroshige
authors.initials: H
authors.lastname: Saito
authors.forename: Hisahiro
authors.initials: H
authors.lastname: Matsubara
mesh_terms: D000368:Aged; D003082:Colectomy; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D059035:Perioperative Period
chemical_list: C007133:hydrocortisone hemisuccinate; D006854:Hydrocortisone