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Resection of the liver for colorectal carcinoma metastases - A multi-institutional study of long-term survivors

Hughes, KS and Rosenstein, RB and Songhorabodi, S and Adson, MA and Ilstrup, DM and Fortner, JG and Maclean, BJ and Foster, JH and Daly, JM and Fitzherbert, D and Sugarbaker, PH and Iwatsuki, S and Starzl, T and Ramming, KP and Longmire, WP and O'Toole, K and Petrelli, NJ and Herrera, L and Cady, B and McDermott, W and Nims, T and Enker, WE and Coppa, GF and Blumgart, LH and Bradpiece, H and Urist, M and Aldrete, JS and Schlag, P and Hohenberger, P and Steele, G and Hodgson, WJ and Hardy, TG and Harbora, D and McPherson, TA and Lim, C and Dillon, D and Happ, R and Ripepi, P and Villella, E and Smith, W and Rossi, RL and Remine, SG and Oster, M and Connolly, DP and Abrams, J and Al-Jurf, A and Hobbs, KEF and Li, MKW and Howard, T and Lee, E (1988) Resection of the liver for colorectal carcinoma metastases - A multi-institutional study of long-term survivors. Diseases of the Colon & Rectum, 31 (1). 1 - 4. ISSN 0012-3706

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In this review of a collected series of patients undergoing hepatic resection for colorectal metastases, 100 patients were found to have survived greater than five years from the time of resection. Of these 100 long-term survivors, 71 remain disease-free through the last follow-up, 19 recurred prior to five years, and ten recurred after five years. Patient characteristics that may have contributed to survival were examined. Procedures performed included five trisegmentectomies, 32 lobectomies, 16 left lateral segmentectomies, and 45 wedge resections. The margin of resection was recorded in 27 patients, one of whom had a positive margin, nine of whom had a less than or equal to 1-cm margin, and 17 of whom had a greater than 1-cm margin. Eighty-one patients had a solitary metastasis to the liver, 11 patients had two metastases, one patient had three metastases, and four patients had four metastases. Thirty patients had Stage C primary carcinoma, 40 had Stage B primary carcinoma, and one had Stage A primarycarcinoma. The disease-free interval from the time of colon resection to the time of liver resection was less than one year in 65 patients, and greater than one year in 34 patients. Three patients had bilobar metastases. Four of the patients had extrahepatic disease resected simultaneously with the liver resection. Though several contraindications to hepatic resection have been proposed in the past, five-year survival has been found in patients with extrahepatic disease resected simultaneously, patients with bilobar metastases, patients with multiple metastases, and patients with positive margins. Five-year disease-free survivors are also present in each of these subsets. It is concluded that five-year survival is possible in the presence of reported contraindications to resection, and therefore that the decision to resect the liver must be individualized. © 1988 American Society of Colon and Rectal Surgeons.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Hughes, KS
Rosenstein, RB
Songhorabodi, S
Adson, MA
Ilstrup, DM
Fortner, JG
Maclean, BJ
Foster, JH
Daly, JM
Fitzherbert, D
Sugarbaker, PH
Iwatsuki, S
Starzl, Ttes11@pitt.eduTES11
Ramming, KP
Longmire, WP
O'Toole, K
Petrelli, NJ
Herrera, L
Cady, B
McDermott, W
Nims, T
Enker, WE
Coppa, GF
Blumgart, LH
Bradpiece, H
Urist, M
Aldrete, JS
Schlag, P
Hohenberger, P
Steele, G
Hodgson, WJ
Hardy, TG
Harbora, D
McPherson, TA
Lim, C
Dillon, D
Happ, R
Ripepi, P
Villella, E
Smith, W
Rossi, RL
Remine, SG
Oster, M
Connolly, DP
Abrams, J
Al-Jurf, A
Hobbs, KEF
Howard, T
Lee, E
Centers: Other Centers, Institutes, Offices, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 January 1988
Date Type: Publication
Journal or Publication Title: Diseases of the Colon & Rectum
Volume: 31
Number: 1
Page Range: 1 - 4
DOI or Unique Handle: 10.1007/bf02552560
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0012-3706
Other ID: uls-drl:31735062129741, Starzl CV No. 823
PubMed ID: 3366020
Date Deposited: 08 Apr 2010 17:14
Last Modified: 29 Jan 2019 15:55


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