Suitable Hepatectomy Procedure for the Liver Metastasis of Colorectal Cancer

Kuniya Tanaka, Shinji Togo, Mituyoshi Ota, Yoshirou Fujii, Yasuhiko Nagano, Itaru Endo, Hitoshi Sekido and Hiroshi Shimada

Department of Surgery II, Yokohama City University School of Medicine

Patterns of residual liver recurrence after hepatectomy were examined to determine suitable hepatectomy for liver metastasis in colorectal cancer. Positive tumor margin and no adjuvant chemotherapy via the hepatic artery (HAI) were risk factors for residual liver recurrence after initial hepatectomy. Positive tumor margin and minor hepatectomy smaller than 1 segmentectomy were risk factors for liver recurrence after a second hepatectomy. Recurrent patterns were classified into 3 types based on the location of recurrent tumors, with multiple recurrence the most common pattern after initial hepatectomy. In contrast, recurrence close to the resected surface was most common for the second hepatectomy. Chronological examination for the onset of recurrence showed that a recurrent tumor originated in the primary colorectal tumor the initial hepatectomy. Conversely, a recurrent tumotr occurred from a metastatic liver tumor after the second hepatectomy. We concluded that partial hepatectomy with tumor-free margin followed by postoperative HAI is most appropriate for the first hepatectomy. Segmentectomy or further surgery may be necessary, however, for a second hepatectomy for residual liver recurrence.

Key words
liver metastasis from colorectal cancer, hepatectomy, residual liver recurrence

Reprint requests
Kuniya Tanaka Department of Surgery, Yokohama City University School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004 JAPAN

Accepted
March 28, 2001

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