Abstracts Only
SSAT residents Corner
Find SSAT on Facebook SSAT YouTube Channel Follow SSAT on Twitter
2007 Program and Abstracts | 2007 Posters
Repeat Surgery for Liver/Lung Metastases After Hepatectomy of Colorectal Liver Metastases - Outcomes and Prognostic Factors
Zenichi Morise*, Atsushi Sugioka, Sojun Hoshimoto, Takazumi Kato, Masahiro Ikeda, Takashi Suda, Yoshinobu Hattori, Harunobu Sato, Kotaro Maeda
Department of Surgery, Fujita Health University School of Medicine, Toyoake, Japan

Hepatic resection for colorectal metastases was performed for 196 patients (99 with multiple metastases) until 2005 in our hospital. Among them, there are 32, 30, and 18 patients who underwent repeat hepatectomy, pulmonary resection for metastases, and 3 or more resections of the liver and/or the lung, respectively. We evaluate outcomes and prognostic factors (Duke's stage, lymph node involvement, pathological differentiation, location of original site; number, size, temporal relationship, resection margin of 1st hepatectomy; number, size, temporal relationship, CEA level of repeat surgery) for those patients.Overall survival rates after 1st hepatectomy are 42.2, 33.4% for 5, 10 years, respectively. (27.9, 18.8% for multiple metastases.)5, 10-year-survival rates after 2nd hepatectomy and pulmonary resection are 31.9, 31.9 and 33.4, 26.7 %, respectively. 5,10-year-survival rates from the 1st surgery of those groups are 48.7, 34.8 and 48.2, 32.2 % (higher than those of overall cases).The 5, 10-year-survival rates from the 1st surgery of patients who underwent 3 or more resections of the liver and/or lung are 51.3, 25.7 %.Among 134 cases, 40 cases actually survived more than 5 years. They are including 14 (of 69) cases with multiple metastases and 8 out of those cases underwent multiple surgeries.Patients’ backgrounds and factors of original site are similar in the groups of 2nd hepatectomy and pulmonary resection as overall cases, except repeat surgery patients are younger. At the time of repeat resection, sizes of tumors are 1.4-7.5 (median 3.6) cm and 0.8-5.0 (median 2.2) cm, numbers of tumors are 1-12 (median 1) and 1-5 (median 1), time durations before surgery are 1-72 (median 12) months and 0-86 (median 9.5) months, plasma CEA levels before surgery are not detectable-310 (median 6.2) and not detectable-30 (median 1.6), for 2nd hepatectomy and pulmonary resection, respectively.For 2nd hepatectomy, significant prognostic factors are lymph node involvement of original site, and number (of tumors) and temporal relationship of repeat surgery. Only lymph node involvement of original site is a significant prognostic factor for pulmonary resectionFor the patients with hepatectomy of colorectal liver metastases, repeat hepatectomy and pulmonary resection for the metastases results in identical survivals and contribute to the improving prognosis of the patients. The prognostic factors related to 1st hepatectomy are not significant and lymph node involvement of original site is a significant prognostic factor for both groups. However, the factors from the conditions related to repeat surgery are significant only for repeat hepatectomy patients.


2007 Program and Abstracts | 2007 Posters
Quick Links
About the SSAT
Membership
Pay Membership Dues
Meetings & Education
Awards
Foundation
Publications
Advocacy
Donate Today