Resection strategy for colorectal liver metastasis focusing on intrahepatic vessels and resection margins.
Surg Today
; 51(9): 1440-1445, 2021 Sep.
Article
em En
| MEDLINE
| ID: mdl-33675410
ABSTRACT
PURPOSE:
We analyzed the impact of surgical margins and vessel preservation on the oncological outcomes of patients with colorectal liver metastases (CRLM).METHODS:
In this retrospective study, resected CRLM (n = 242) from 116 patients were assigned to one of the following groups Group A, apart from vessels (n = 201); Group B, hepatic vein contact (n = 27); or Group C, Glissonean pedicle contact (n = 25). We analyzed the local recurrence rates (LRR) in each group.RESULTS:
The total LRR and that in Groups A, B, and C were 11.6%, 10.4%, 7.4%, and 20%, respectively. In group A, R1 resections were associated with a significantly higher LRR than R0 resections (27.6% vs 7.6%, respectively; P = 0.001); however, the margin widths were not related to the LRR. In group B, the LRR for hepatic vein preservation and resection did not differ. In group C, the Glissonean pedicle preservation group had a higher LRR than the Glissonean pedicle resection group (66.7% vs 5.3%, respectively; P = 0.001). The 5-year overall survival rate of the local recurrence group (25%) was significantly lower than that of the no recurrence group (84%, P < 0.001) and the intrahepatic recurrence group (60%, P = 0.026).CONCLUSION:
R0 resections for CRLM, apart from those involving vessels, can achieve local control. While preserving hepatic vein contact with CRLM is acceptable, the Glissonean pedicle should be resected because of the higher LRR.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Colorretais
/
Margens de Excisão
/
Hepatectomia
/
Fígado
/
Neoplasias Hepáticas
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Surg Today
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Japão