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Interval hepatic resection of colorectal metastases improves patient selection.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Colacchio, Thomas Anthony |
| Copyright Year | 2000 |
| Abstract | HYPOTHESIS Interval reevaluation for resectability of hepatic colorectal metastases aids patient selection. DESIGN A retrospective review. SETTING A tertiary care medical center. PATIENTS AND METHODS From January 1, 1985, to July 1, 1998, 318 patients with colorectal hepatic metastases were identified. Resectable lesions (N = 73) were divided into synchronous (n = 36) or metachronous (n = 37) and retrospectively reviewed for immediate resection or interval reevaluation. Kaplan-Meier survival curves of treatment groups were compared by the log-rank test. RESULTS Survival curves of patients with synchronous and metachronous lesions undergoing interval reevaluation vs. immediate resection were not significantly different (P = .74 and P = .65, respectively). No lesions from patients who underwent interval reevaluation became unresectable due to growth of the initial metastases. After interval reevaluation, 8 (29%) of 28 patients with synchronous metastases were spared the morbidity of laparotomy because of distant or an increased number of metastases and 10 (36%) of 28 patients were spared the morbidity of hepatic resection at the time of interval laparotomy. Actuarial median and 5-year survival of patients after delayed hepatic resection (51 months and 45%, respectively) were significantly improved compared with those of all other patients with resectable metastases (23 months and 7%, respectively) (P = .02). For patients with metachronous lesions who underwent interval reevaluation, 4 (29%) of 14 patients were spared the morbidity of laparotomy because of an increased number of hepatic or distant metastases. CONCLUSIONS Delaying hepatic resection for metastatic colorectal cancer does not impair survival. Potentially, two thirds of patients can avoid maj or hepatic surgery. For synchronous metastases, delaying hepatic resection appears to select patients who will benefit from hepatic resection. |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://archsurg.jamanetwork.com/journals/SURG/articlepdf/390566/sne9016.pdf |
| PubMed reference number | 10768715v1 |
| Volume Number | 135 |
| Issue Number | 4 |
| Journal | Archives of surgery |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Colorectal Carcinoma Colorectal Neoplasms Excision Laparotomy Liver diseases Morbidity - disease rate Neoplasm Metastasis Neoplasms, Multiple Primary Patients Tertiary Healthcare bone metastases prevention/treatment liver metastases unresectable |
| Content Type | Text |
| Resource Type | Article |
