Staged hepatectomy for bilobar colorectal hepatic metastases

HPB (Oxford). 2012 Nov;14(11):782-9. doi: 10.1111/j.1477-2574.2012.00543.x. Epub 2012 Aug 26.

Abstract

Objectives: This study describes the management of patients with bilobar colorectal liver metastases (CRLM).

Methods: A retrospective collection of data on all patients with CRLM who were considered for staged resection (n= 85) from January 2003 to January 2011 was performed. Patients who underwent one hepatic resection were considered to have had a failed staged resection (FSR), whereas those who underwent a second or third hepatic resection to produce a cure were considered to have had a successful staged resection (SSR). Survival was calculated from the date of diagnosis of liver metastases. Complete follow-up and dates of death were obtained from the Government of Quebec population database.

Results: Median survival was 46 months (range: 30-62 months) in the SSR group and 22 months (range: 19-29 months) in the FSR group. Rates of 5-year survival were 42% and 4% in the SSR and FSR groups, respectively. Fifteen of the 19 patients who remained alive at the last follow-up date belonged to the SSR group.

Conclusions: In patients in whom staged resection for bilobar CRLM is feasible, surgery would appear to offer benefit.

MeSH terms

  • Aged
  • Chi-Square Distribution
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / pathology*
  • Disease-Free Survival
  • Female
  • Hepatectomy / adverse effects
  • Hepatectomy / methods*
  • Hepatectomy / mortality
  • Humans
  • Kaplan-Meier Estimate
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / mortality
  • Liver Neoplasms / secondary*
  • Liver Neoplasms / surgery*
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Quebec
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome