Study of Multiple Factors for Prognosis and Recurrence after Hepatic Resection for Metastasis from Colorectal Cancer

Kazuo Hatsuse, Akira Komiyama, Noriyuki Kunimatsu, Makoto Maemura, Hideki Aoki, Sinji Yamamoto, Minoru Kakihara, Kazuo Hase, Hidetaka Mochizuki, Shoetsu Tamakuma

The First Department of Surgery, National Defense Medical College

Twenty-nine patients with hepatic metastasis from colorectal cancer were reviewed for their long-term surgical outcome after hepatic resection. The extent and the multiplicity of the hepatic metastasis was categorized as H₁, H₂, H₃ according to the general rules for clinical and pathological studies on cancer of colon, rectum and anus. This study found 3 year survival rates of 54%, 0%, 33% and 0% for patients with resected H₁, unresected H₁, resected H₂ and unresected H₂, respectively. The difference between the resected and unresected cases was statistically significant for both in H₁ and H₂ metastasis. In the 2l resected H₁ patients, the influence of several factors on survival rate was evaluated. The factors included age, sex, operative procedure, timing of operation, number and size of metastatic lesions and the effect of transcatheter arterial embolization (TAE). Maleness was the only variable that had a favorable influence on prognosis. In light of the fact that there was no significant difference in terms of prognosis between partial resection and anatomical segmental resection, partial resection was considered adequate for H₁ liver metastasis. The incidence of recurrence after the resection of H₁ liver metastasis was 52% (11 cases), with the liver the most common site of recurrence (73%, 8 cases). Based on the above-mentioned findings, resection is recommended for hepatic metastasis from colorectal cancer, with partial resection used as a standard procedure, but recurrence in the residual liver is so frequent that measures should be taken to prevent it.

Key words
liver metastasis of colorectal cancer, factors influencing on prognosis, hepatic resection

Reprint requests
Kazuo Hatsuse First Department of Surgery, National Defense Medical College
3-2 Namiki, Tokorozawa, 359 JAPAN

Accepted
November 19, 1990

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