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

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

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.

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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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Conflicts of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan

    Yoshihiro Inoue, Michihiro Hayashi, Koji Komeda, Shinsuke Masubuchi, Masashi Yamamoto, Hidenori Yamana, Hajime Kayano, Tetsunosuke Shimizu, Mitsuhiro Asakuma, Fumitoshi Hirokawa, Yoshiharu Miyamoto & Kazuhisa Uchiyama

  2. Department of Pathology, Osaka Medical College Hospital, Takatsuki, Japan

    Atsushi Takeshita & Yuro Shibayama

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  1. Yoshihiro Inoue
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Correspondence to Yoshihiro Inoue.

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Inoue, Y., Hayashi, M., Komeda, K. et al. Resection Margin with Anatomic or Nonanatomic Hepatectomy for Liver Metastasis from Colorectal Cancer. J Gastrointest Surg 16, 1171–1180 (2012). https://doi.org/10.1007/s11605-012-1840-7

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  • DOI: https://doi.org/10.1007/s11605-012-1840-7

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