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Surgery for multiple hepatic colorectal metastases.

Norihiro Kokudo¹, Hiroshi Imamura, Yasuhiko Sugawara

¹Department of Surgery, Hepato-Biliary-Pancreatic Surgery Division, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.

Journal of Hepato-Biliary-Pancreatic Surgery

|May 6, 2004

Summary

Hepatic resection for multiple colorectal metastases is effective, even with four or more tumors. The number of nodules resected should be based on safety and feasibility, as cure is possible.

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Area of Science:

Oncology
Surgical Oncology
Gastroenterology

Background:

Colorectal cancer frequently metastasizes to the liver.
Hepatic resection is a potential curative treatment for liver metastases.
The role of liver resection for multiple colorectal metastases remains debated.

Purpose of the Study:

To evaluate the prognostic significance of tumor number in hepatic resection for colorectal metastases.
To determine contraindications for hepatic resection based on tumor burden.
To establish guidelines for the number of nodules to resect.

Main Methods:

Review of institutional data on patients undergoing hepatic resection for colorectal metastases.
Analysis of survival outcomes based on the number of liver tumors.

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Literature review of reported cases and outcomes.

Main Results:

The number of tumors is a significant prognostic factor, with worse survival for multiple metastases compared to single metastasis.
Survival curves for patients with two to three nodules were similar to those with four or more nodules.
Patients with four or more metastases demonstrated comparable or better survival than expected.

Conclusions:

Hepatic resection should be considered for patients with four or more colorectal metastases.
The maximum number of resectable nodules is not definitively established and continues to increase in reported cases.
Surgery for multiple liver metastases is justified if safe and technically feasible, offering a potential cure.