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Liver resection for metastatic colorectal cancer in patients with concurrent extrahepatic disease: results in 127 patients treated at a single center
Annals of Surgical Oncology, 06/09/09

Carpizo DR et al. - In a study to characterize survival, recurrence rates, and factors associated with outcome, it was shown that concurrent resection of hepatic and extrahepatic disease (EHD) in well-selected pts is associated with a possibility of long-term survival. The presence of limited and resectable EHD should not be an absolute contraindication to resection. The site of EHD and the nearly universal recurrence rate must be taken into consideration.

Methods

1369 pts underwent resection of hepatic colorectal metastases, of whom 127 (9%) had concurrent resection of EHD.
Survival and recurrence were compared between pts with and without EHD.
Survival data were stratified by site of metastatic involvement.
Variables potentially associated with survival were analyzed in univariate and multivariate analyses.

Results

Median follow-up was 24 mos.
3- and 5-yr survival for pts with concomitant EHD were 47% and 26%, respectively, compared with 67% and 49%, for those without EHD.
Among pts with EHD, multivariate analysis identified higher clinical risk score, incomplete resection of all EHD, EHD detected intraoperatively, and having received neoadjuvant chemotherapy to be independently associated with a worse survival.
Pts with portal lymph node metastases had worse survival than those with lung or ovarian metastases.
Among pts who had a complete resection of all disease, 95% recurred.

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