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Long‐term outcome of liver resection for colorectal metastases in the presence of extrahepatic disease: A multi‐institutional Japanese study
Ist Teil von
Journal of hepato-biliary-pancreatic sciences, 2020-11, Vol.27 (11), p.810-818
Ort / Verlag
Tokyo: Wiley Subscription Services, Inc
Erscheinungsjahr
2020
Quelle
Alma/SFX Local Collection
Beschreibungen/Notizen
Background/Purpose
The purpose of the present study was to assess long‐term outcomes following liver resection for colorectal liver metastases (CRLM) with concurrent extrahepatic disease and to identify the preoperative prognostic factors for selection of operative candidates.
Methods
In this retrospective, multi‐institutional study, 3820 patients diagnosed with CRLM during 2005–2007 were identified using nationwide survey data. Data of identified patients with concurrent extrahepatic lesions were analyzed to estimate the impact of liver resection on overall survival (OS) and to identify preoperative, prognostic indicators.
Results
Three‐ and 5‐year OS rates after liver resection in 251 CRLM patients with extrahepatic disease (lung, n = 116; lymph node, n = 51; peritoneal, n = 37; multiple sites, n = 23) were 50.2% and 32.0%, respectively. Multivariate analysis revealed that a primary tumor in the right colon, lymph node metastasis from the primary tumor, serum carbohydrate antigen (CA) 19‐9 level >37 UI/mL, the site of extrahepatic disease, and residual liver tumor after hepatectomy were associated with higher mortality. We proposed a preoperative risk scoring system based on these factors that adequately discriminated 5‐year OS after liver resection in training and validation datasets.
Conclusions
Performing R0 liver resection for colorectal liver metastases with treatable extrahepatic disease may prolong survival. Our proposed scoring system may help select appropriate candidates for liver resection.
Highlight
In this retrospective nationwide study comprising 251 patients, Sawada and colleagues found that R0 liver resection for colorectal liver metastases with treatable extrahepatic disease prolonged survival. To help select appropriate candidates for liver resection, they propose a preoperative risk scoring system that adequately discriminated 5‐year overall survival after liver resection.