Journal of Gastrointestinal Surgery

, Volume 16, Issue 6, pp 1171–1180 | Cite as

Resection Margin with Anatomic or Nonanatomic Hepatectomy for Liver Metastasis from Colorectal Cancer

  • Yoshihiro Inoue
  • Michihiro Hayashi
  • Koji Komeda
  • Shinsuke Masubuchi
  • Masashi Yamamoto
  • Hidenori Yamana
  • Hajime Kayano
  • Tetsunosuke Shimizu
  • Mitsuhiro Asakuma
  • Fumitoshi Hirokawa
  • Yoshiharu Miyamoto
  • Atsushi Takeshita
  • Yuro Shibayama
  • Kazuhisa Uchiyama
Original Article

Abstract

Background

When hepatectomy is used as a primary treatment for liver metastasis from colorectal cancer (CRCLM), the balance between surgical curability and functional preservation of the remnant liver is of great importance.

Methods

A total of 108 patients who underwent initial hepatectomy for CRCLM were retrospectively analyzed with respect to tumor extent, operative method, and prognosis, including recurrence.

Results

The 1-, 2-, 3-, and 5-year overall survival rates (OS) for all patients were 90.5%, 77.8%, 63.2%, and 51.6%, respectively. Multivariate analysis indicated serum carbohydrate antigen 19-9 (CA 19-9) level after hepatectomy (<36 or ≥36 mAU/mL) and presence of recurrence as independent prognostic factors of OS (P = 0.0458 and 0.0249, respectively), and tumor depth of colorectal cancer (<se (a2) vs. ≥se (a2)) and serum CA 19-9 level after hepatectomy as the significant factors affecting disease-free survival (DFS) (P = 0.0025 and 0.00138, respectively). Neither resection margin nor type of hepatectomy (anatomic or nonanatomic) for CRCLM was a significant prognostic factor for OS or DFS or CRCLM recurrence, including intrahepatic recurrence.

Conclusions

In CRCLM, we believe that nonanatomic hepatectomy with narrow margin is indicated, and optimal treatment would include functional preservation of as much of the remnant liver as possible.

Keywords

Liver metastasis from colorectal cancer Resection margin width Type of hepatectomy Intrahepatic recurrence 

Abbreviations

CRC

Colorectal cancer

CRCLM

Liver metastasis from colorectal cancer

CEA

Carcinoembryonic antigen

CA 19-9

Carbohydrate antigen 19-9

HCC

Hepatocellular carcinoma

AST

Aspartate aminotransferase

ALT

Alanine aminotransferase

ICG-R15

Indocyanine green retention rate at 15 min

HBV

Hepatitis B virus

HBsAg

Hepatitis B virus surface antigen

HCV

Hepatitis C virus

CT

Computed tomography

MRI

Magnetic resonance imaging

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Copyright information

© The Society for Surgery of the Alimentary Tract 2012

Authors and Affiliations

  • Yoshihiro Inoue
    • 1
  • Michihiro Hayashi
    • 1
  • Koji Komeda
    • 1
  • Shinsuke Masubuchi
    • 1
  • Masashi Yamamoto
    • 1
  • Hidenori Yamana
    • 1
  • Hajime Kayano
    • 1
  • Tetsunosuke Shimizu
    • 1
  • Mitsuhiro Asakuma
    • 1
  • Fumitoshi Hirokawa
    • 1
  • Yoshiharu Miyamoto
    • 1
  • Atsushi Takeshita
    • 2
  • Yuro Shibayama
    • 2
  • Kazuhisa Uchiyama
    • 1
  1. 1.Department of General and Gastroenterological SurgeryOsaka Medical College HospitalOsakaJapan
  2. 2.Department of PathologyOsaka Medical College HospitalTakatsukiJapan

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