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Resection of the liver for colorectal carcinoma metastasesA multi‐institutional study of long‐term survivors

 

作者: Kevin Hughes,   Rebecca Rosenstein,   Sate Songhorabodi,   Martin Adson,   Duane Ilstrup,   Joseph Fortner,   Barbara Maclean,   James Foster,   John Daly,   Diane Fitzherbert,   Paul Sugarbaker,   Shunzaboro Iwatsuki,   Thomas Starzl,   Kenneth Ramming,   William Longmire,   Kathy O'Toole,   Nicholas Petrelli,   Lemuel Herrera,   Blake Cady,   William McDermott,   Thomas Nims,   Warren Enker,   Gene Coppa,   Leslie Blumgart,   Howard Bradpiece,   Marshall Urist,   Joaquin Aldrete,   Peter Schlag,   Peter Hohenberger,   Glenn Steele,   John Hodgson,   Thomas Hardy,   Denise Harbora,   Alexander McPherson,   Christoper Lim,   Daniel Dillon,   Richard Happ,   Phillip Ripepi,   Edward Villella,   William Smith,   Ricardo Rossi,   Stephen Remine,   Mary Oster,   David Connolly,   Jerome Abrams,   Adel Al‐Jurf,   K. Hobbs,   Michael Li,   Ted Howard,   Emonuel Lee,  

 

期刊: Diseases of the Colon & Rectum  (OVID Available online 1988)
卷期: Volume 31, issue 1  

页码: 1-4

 

ISSN:0012-3706

 

年代: 1988

 

出版商: OVID

 

关键词: Hepatic metastases;Cancer;Colorectal neoplasms;Hepatic resection

 

数据来源: OVID

 

摘要:

&NA;In this review of a collected series of patients undergoing hepatic resection for colorectal metastases, 100 patients were found to have survived greater than five years from the time of resection. Of these 100 long‐term survivors, 71 remain disease‐free through the last follow‐up, 19 recurred prior to five years, and ten recurred after five years. Patient characteristics that may have contributed to survival were examined. Procedures performed included five trisegmentectomies, 32 lobectomies, 16 left lateral segmentectomies, and 45 wedge resections. The margin of resection was recorded in 27 patients, one of whom had a positive margin, nine of whom had a less than or equal to 1‐cm margin, and 17 of whom had a greater than 1‐cm margin. Eighty‐one patients had a solitary metastasis to the liver, 11 patients had two metastases, one patient had three metastases, and four patients had four metastases. Thirty patients had Stage C primary carcinoma, 40 had Stage B primary carcinoma, and one had Stage A primarycarcinoma. The disease‐free interval from the time of colon resection to the time of liver resection was less than one year in 65 patients, and greater than one year in 34 patients. Three patients had bilobar metastases. Four of the patients had extrahepatic disease resected simultaneously with the liver resection. Though several contraindications to hepatic resection have been proposed in the past, five‐year survival has been found in patients with extrahepatic disease resected simultaneously, patients with bilobar metastases, patients with multiple metastases, and patients with positive margins. Five‐year disease‐free survivors are also present in each of these subsets. It is concluded that five‐year survival is possible in the presence of reported contraindications to resection, and therefore that the decision to resect the liver must be individualized.

 

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