Two-Stage Resection for Bilobar Colorectal Liver Metastases: R0 Resection Is the Key

Background Two-stage liver resection (2-SLR) is used clinically in conjunction with portal vein embolization for bilobar disease to increase the number of patients suitable for liver resection. The long-term outcomes after 2-SLR for multiple bilobar colorectal liver metastases (CLM) was examined. Me...

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Bibliographic Details
Published in:Annals of surgical oncology 2011-07, Vol.18 (7), p.1939-1946
Main Authors: Tsim, Nicole, Healey, Andrew J., Frampton, Adam E., Habib, Nagy A., Bansi, Devinder S., Wasan, Harpreet, Cleator, Susan J., Stebbing, Justin, Lowdell, Charles P., Jackson, James E., Tait, Paul, Jiao, Long R.
Format: Article
Language:English
Subjects:
Aged
Catheter Ablation
Cohort Studies
Colorectal Neoplasms - pathology
Colorectal Neoplasms - surgery
Embolization, Therapeutic
Female
Follow-Up Studies
Hepatectomy
Hepatobiliary Tumors
Humans
Liver Neoplasms - secondary
Liver Neoplasms - surgery
Male
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Recurrence, Local - pathology
Neoplasm Recurrence, Local - surgery
Neoplasm Staging
Oncology
Portal Vein - pathology
Portal Vein - surgery
Prospective Studies
Reoperation
Surgery
Surgical Oncology
Survival Rate
Treatment Outcome
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Summary:Background Two-stage liver resection (2-SLR) is used clinically in conjunction with portal vein embolization for bilobar disease to increase the number of patients suitable for liver resection. The long-term outcomes after 2-SLR for multiple bilobar colorectal liver metastases (CLM) was examined. Methods Patients who sought care between November 2003 and April 2006 with multiple CLM considered suitable for 2-SLR were prospectively followed. Clinicopathological data were collected. Surgical outcomes were defined as complete clearance of tumor (R0/R1/R2), postoperative morbidity (within 3 months), 30 day mortality, disease-free survival (DFS), and overall survival (OS). Results A total of 131 patients with CLM underwent liver resection during the study period, 38 of whom were planned for a 2-SLR for multiple bilobar disease. Only 33 (87%) completed the 2-SLR with a curative intent. Five patients did not undergo stage II resection because of disease progression . The postoperative morbidity was 11 and 33% after stage I and stage II liver resections, respectively. Five patients (13%) encountered postoperative complications specific to liver surgery. The median interval from stage II resection to disease recurrence in the R0 group was 18 months versus 3 months in the R1/R2 group ( P  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-010-1533-y