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Journal of Nippon Medical School

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Outcome of Surgical Treatment of Synchronous Liver Metastases from Colorectal Cancer

Nobuhiko Taniai, Hiroshi Yoshida, Yasuhiro Mamada, Satoshi Matsumoto, Yoshiaki Mizuguchi, Hideyuki Suzuki, Kiyonori Furukawa, Koho Akimaru and Takashi Tajiri

Surgery for Organ Function and Biological Regulation, Nippon Medical School Graduate School of Medicine


Background: We retrospectively identified the prognostic factors in cases of synchronous liver metastases from colorectal cancer and established a clinical strategy at our institution.
Methods: One hundred eight patients with hepatic metastases from colorectal cancer underwent a first radical hepatic resection. Of these, 67 were diagnosed with hepatic synchronous metastases from colorectal primaries (S group) and 41 were diagnosed with metachronous metastases (M group). Hepatic lesions were diagnosed concurrently with the primary lesions in 45 of the 67 patients in the S group. Of these 45 patients, 37 underwent synchronous hepatectomy (SH group) and 8 underwent metachronous hepatectomy (MH group).
Results: The overall 3-, 5- and 10-year survival rates were 51.4%, 41.6%, and 30.9%, respectively. There were no significant differences between the S and M groups in overall survival. Univariate analysis of the S group revealed significant differences in survival based on tumor factor, pathological lymph node metastases of the primary tumor, and the tumor-free margin. There were no significant differences between the SH and MH groups in overall survival.
Conclusions: Patients with synchronous liver metastases from colorectal cancer should undergo radical resection of the primary lesion and simultaneous hepatectomy with an adequate tumor-free margin as a standard surgical course.

J Nippon Med Sch 2006; 73: 82-88

Keywords
liver metastases from colorectal cancer, synchronous metastases, prognostic factor, survival rates, tumor-free margin

Correspondence to
Nobuhiko Taniai, MD, First Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
Taniain@nms.ac.jp

Received, January 23, 2006
Accepted, March 6, 2006