Recurrence Patterns after Hepatic Resection for Metastases from Colorectal Cancer

Hidenobu Masui, Hideyuki Ike, Shinji Togo, Shigeki Yamaguchi, Syouichi Fujii, Eisyuu Kanemura, Masao Nanko, Haruki Kurosawa, Shigeo Oki, Hiroshi Shimada

Second Department of Surgery, Yokohama City University, School of Medicine

Eighty-eight patients who had undergone hepatic resection for hepatic metastases from colorectal cancer were reviewed. The cumulative 3-year recurence rate and the 3-year hepatic recurrence rate were 74.9% and 65.2%, respectively. The initial recurrence occurred in the liver in 73.3% and in the lung in 13.3% of the patients. Hepatic recurrence rates after hepatectomy were not influenced by distribution, number, or size of the metastases or the procedure of hepatectomy. However, the hepatic recurrence rate was significantly better in patients with a surgical margin more than 1 cm than in those with a smaller surgical margin. Hepatic recurrence near the resecting plane (<4 cm) was thought to be related to micrometastasis from macroscopic metastasis (daughter metastasis) and recurrence far from the resecting plane (>4 cm) was thought to be related to occult hepatic metastasis from the primary lesion. According to this theory, hepatic recurrence was caused by daughter metastasis in 29.3% and by occult metastasis in 70.7%. Accordingly, hepatic resection with an adequate surgical margin and postoperative intraarterial chemotherapy for daughter metastasis and occlut metastasis was thought to be indispensable, to prevent recurrence in the remnant liver.

Key words
hepatic metastases from colorectal cancer, hepatic resection, recurrence in remnant liver, recurrence pattern

Reprint requests
Hidenobu Masui Second Department of Surgery, Yokohama City University, School of Medicine
3-9 Fukura, Kanazawa-ku, Yokohama, 236 JAPAN

Accepted
October 9, 1996

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