AGGRESSIVE REPEAT LIVER RESECTION FOR HEPATIC METASTASES OF COLORECTAL-CARCINOMA

被引：24

作者：

NAKAMURA, S

SAKAGUCHI, S

NISHIYAMA, R

SUZUKI, S

YOKOI, Y

BABA, S

MARO, H

机构：

[1] Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu-shi, 431-31

[2] Second Department of Pathology, Hamamatsu University School of Medicine, Hamamatsu

来源：

SURGERY TODAY | 1992年 / 22卷 / 03期

关键词：

COLORECTAL CARCINOMA; HEPATIC METASTASES; HEPATECTOMY;

D O I：

10.1007/BF00308832

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Although hepatectomy for liver metastases from colorectal carcinoma is an effective treatment, recurrence in the liver is still the most common site after hepatectomy. Thirty patients underwent hepatectomy for hepatic metastases and 17 of them had recurrence in the remnant liver during the following 12-year period. Six of the 17 patients underwent a removal of isolated hepatic recurrences. Two of the six patients underwent a third hepatectomy, and three patients underwent partial lung resection on a total of five occasions. There were no operative deaths while complications after a third hepatectomy contributed-to a high morbidity rate of 40 per cent. The mean length of survival of the six patients was 28.5 months from the second hepatectomy. The prognosis of the six patients who underwent a repeat hepatectomy was significantly better than that of patients with unresectable recurrence after an initial hepatectomy (p < 0.01). The overall 5-year survival of 29 patients excluding one in-hospital death was 44.7 per cent. Our results reveal that aggressive removal of isolated and resectable recurrent disease has the potential to improve the prognosis of selected patients with metastatic cancer.

引用

页码：260 / 264

页数：5

共 22 条

[1] Welch J.P., Donaldson G.A., Detection and treatment of recurrent cancer of the colon and rectum, Am J Surg, 135, pp. 505-511, (1978)
[2] Adson M.A., van Heerden J.A., Adson M.H., Wagner J.S., Ilstrup D.M., Resection of hepatic metastases from colorectal cancer, Arch Surg, 119, pp. 647-651, (1984)
[3] Iwatsuki S., Shaw B., Starzl T.E., Experience with 150 liver resections, Ann Surg, 197, pp. 247-253, (1983)
[4] Bengmark S., Hafstrom L., The natural history of primary and secondary malignant tumors of the liver. I. The prognosis for patients with hepatic metastases from colonic and rectal carcinoma by laparotomy, Cancer, 23, pp. 198-202, (1969)
[5] Hughes K.S., Simon R., Songhorabodi S., Adson M.A., Ilstrup D.M., Fortner J.G., Maclean B.J., Foster J.H., Daly J.M., Fitzherbert D., Sugarbaker P.H., Iwatsuki S., Starzl T., Ramming K.P., Longmire W.P., O'Toole K., Petrelli N.J., Herrera L., Cady B., McDermott W., Ni T., Enker W.E., Coppa G.F., Blumgart L.H., Bradpiece H., Urist M., Aldrete J.S., Schlag W.J., Hohenberger P., Steele G., Hodgson W.J., Hardy T.G., Harbora D., McPherson T.A., Lim C., Dillon D., Happ R., Ripepi P., Villella E., Ros
[6] Griffith K.D., Sugarbaker P.H., Chang A.E., Repeat hepatic resections for colorectal metastases, Surgery, 107, pp. 101-104, (1990)
[7] Lange J.F., Leese T., Castaing D., Bismuth H., Repeat hepatectomy for recurrent malignant tumors of the liver. Surg Gynecol, Obstet, 169, pp. 119-126, (1989)
[8] Makuuchi M., Uesaka K., Takayama T., Kosuge T., Yamazaki S., Hasegawa H., Operation for recurrent cancer, Hepatoma (in Japanese) Geka-Shinryo, 30, pp. 1388-1398, (1988)
[9] Stone M.D., Cady B., Jenkins R.L., McDermott W.V., Steele G.D., Surgical therapy for recurrent liver metastases from colorectal cancer, Arch Surg, 125, pp. 718-722, (1990)
[10] Dagradi A.D., Magiante G.L., Marchiori L.A.M., Nicoli N.M., Repeated hepatic resection, Int Surg, 72, pp. 87-92, (1987)

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