Long-term outcome of liver resection for colorectal metastases in the presence of extrahepatic disease: A multi-institutional Japanese study.

Colorectal Neoplasms / surgery Hepatectomy Humans Japan / epidemiology Liver Liver Neoplasms / surgery Prognosis Retrospective Studies
colorectal cancer extrahepatic disease liver metastasis liver resection preoperative risk score

Journal

Journal of hepato-biliary-pancreatic sciences
ISSN: 1868-6982
Titre abrégé: J Hepatobiliary Pancreat Sci
Pays: Japan
ID NLM: 101528587

Informations de publication

Date de publication:
Nov 2020
Historique:
received: 21 04 2020
revised: 06 07 2020
accepted: 20 07 2020
pubmed: 28 7 2020
medline: 16 10 2021
entrez: 27 7 2020
Statut: ppublish

Résumé

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. 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. 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. 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.

Sections du résumé

BACKGROUND/PURPOSE OBJECTIVE
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 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 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 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.

Identifiants

DOI: 10.1002/jhbp.810 PMID: 32713080
pubmed: 32713080
doi: 10.1002/jhbp.810
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

810-818

Subventions

Organisme : The Nakayama Cancer Research Institute

Informations de copyright

© 2020 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

Références

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Auteurs

Yu Sawada (Y)

Joint Committee for Nationwide Survey on Colorectal Liver Metastasis, Tokyo, Japan.
Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan.
ORCID: 0000-0002-5641-1103

Kota Sahara (K)

Joint Committee for Nationwide Survey on Colorectal Liver Metastasis, Tokyo, Japan.
Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan.

Itaru Endo (I)

Joint Committee for Nationwide Survey on Colorectal Liver Metastasis, Tokyo, Japan.
Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan.
ORCID: 0000-0001-5520-8114

Katsunori Sakamoto (K)

Joint Committee for Nationwide Survey on Colorectal Liver Metastasis, Tokyo, Japan.
Department of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
ORCID: 0000-0002-6431-0011

Goro Honda (G)

Joint Committee for Nationwide Survey on Colorectal Liver Metastasis, Tokyo, Japan.
Department of Gastroenterological Surgery, New Tokyo Hospital, Matsudo, Chiba, Japan.
ORCID: 0000-0002-1162-4535

Toru Beppu (T)

Joint Committee for Nationwide Survey on Colorectal Liver Metastasis, Tokyo, Japan.
Department of Surgery, Yamaga City Medical Center, Yamaga, Kumamoto, Japan.

Kenjiro Kotake (K)

Joint Committee for Nationwide Survey on Colorectal Liver Metastasis, Tokyo, Japan.
Department of Surgery, Sano City Hospital, Sano, Tochigi, Japan.

Masakazu Yamamoto (M)

Joint Committee for Nationwide Survey on Colorectal Liver Metastasis, Tokyo, Japan.
Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.

Keiichi Takahashi (K)

Joint Committee for Nationwide Survey on Colorectal Liver Metastasis, Tokyo, Japan.
Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan.
ORCID: 0000-0003-4362-6583

Kiyoshi Hasegawa (K)

Joint Committee for Nationwide Survey on Colorectal Liver Metastasis, Tokyo, Japan.
Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan.
ORCID: 0000-0001-8734-740X

Michio Itabashi (M)

Joint Committee for Nationwide Survey on Colorectal Liver Metastasis, Tokyo, Japan.
Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.

Yojiro Hashiguchi (Y)

Joint Committee for Nationwide Survey on Colorectal Liver Metastasis, Tokyo, Japan.
Department of Surgery, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan.

Yoshihito Kotera (Y)

Joint Committee for Nationwide Survey on Colorectal Liver Metastasis, Tokyo, Japan.
Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.

Shin Kobayashi (S)

Joint Committee for Nationwide Survey on Colorectal Liver Metastasis, Tokyo, Japan.
Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital East, Kashiwa-shi, Chiba, Japan.

Tatsuro Yamaguchi (T)

Joint Committee for Nationwide Survey on Colorectal Liver Metastasis, Tokyo, Japan.
Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan.

Ken Tabuchi (K)

Joint Committee for Nationwide Survey on Colorectal Liver Metastasis, Tokyo, Japan.
Department of Pediatrics, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan.
ORCID: 0000-0001-7739-8780

Hirotoshi Kobayashi (H)

Joint Committee for Nationwide Survey on Colorectal Liver Metastasis, Tokyo, Japan.
Department of Surgery, Teikyo University Hospital, Mizonokuchi, Kawasaki, Kanagawa, Japan.

Kensei Yamaguchi (K)

Joint Committee for Nationwide Survey on Colorectal Liver Metastasis, Tokyo, Japan.
Department of Gastroenterological Chemotherapy, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan.

Satoshi Morita (S)

Joint Committee for Nationwide Survey on Colorectal Liver Metastasis, Tokyo, Japan.
Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Shogoin, Sakyo-ku, Japan.

Soichiro Natsume (S)

Joint Committee for Nationwide Survey on Colorectal Liver Metastasis, Tokyo, Japan.
Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan.

Masaru Miyazaki (M)

International University of Health and Welfare, Mita Hospital, Minato-ku, Tokyo, Japan.

Kenichi Sugihara (K)

Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan.

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Classifications MeSH

questionsmedicales.fr › Maladies de l'appareil digestif › Maladies gastro-intestinales › Maladies intestinales › Maladies du rectum › Tumeurs colorectales › Long-term outcome of liver resection for...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie digestive › Hépatectomie › Long-term outcome of liver resection for...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Long-term outcome of liver resection for...
questionsmedicales.fr › Régions géographiques › Iles › Japon › Long-term outcome of liver resection for...
questionsmedicales.fr › Système digestif › Foie › Long-term outcome of liver resection for...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladies du foie › Tumeurs du foie › Long-term outcome of liver resection for...
questionsmedicales.fr › Diagnostic › Pronostic › Long-term outcome of liver resection for...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Long-term outcome of liver resection for...