Resection of Hepatic Colorectal Metastases Involving the Caudate Lobe

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dc.contributor.author Abdalla, Eddie
dc.contributor.author Ribero, Dario
dc.contributor.author Pawlik, Timothy
dc.contributor.author Zorzi, Daria
dc.contributor.author Curley, Steven
dc.contributor.author Muratore, Andrea
dc.contributor.author Andres, Axel
dc.contributor.author Mentha, Gilles
dc.contributor.author Capussotti, Lorenzo
dc.contributor.author Vauthey, Nicolas
dc.date.accessioned 2015-11-12T12:22:16Z
dc.date.available 2015-11-12T12:22:16Z
dc.date.copyright 2007
dc.date.issued 2015-11-12
dc.identifier.issn 1091-255X en_US
dc.identifier.uri http://hdl.handle.net/10725/2551
dc.description.abstract Purpose: To examine clinical features and outcome of patients who underwent hepatic resection for colorectal liver metastases (LM) involving the caudate lobe. Patients and Methods: Consecutive patients who underwent hepatic resection for LM from May 1990 to September 2004 were analyzed from a multicenter database. Demographics, operative data, pathologic margin status, recurrence, and survival were analyzed. Results: Of 580 patients, 40 (7%) had LM involving the caudate. Six had isolated caudate LM and 34 had LM involving the caudate plus one or more other hepatic segments. Patients with caudate LM were more likely to have synchronous primary colorectal cancer (63% vs. 36%; P = 0.01), multiple LM (70% vs. 51%; P = 0.02) and required extended hepatic resection more often than patients with non-caudate LM (60% vs. 18%; P < 0.001). Only four patients with caudate LM underwent a vascular resection; three at first operation, one after recurrence of a resected caudate tumor. All had primary repair (vena cava, n = 3; portal vein, n = 1). Perioperative complications (43% vs. 28%) and 60-day operative mortality (0% vs. 1%) were similar (caudate vs. non-caudate LM, both P > 0.05). Pathological margins were positive in 15 (38%) patients with caudate LM and in 43 (8%) with non-caudate LM (P < 0.001). At a median follow-up of 40 months, 25 (64%) patients with caudate LM recurred compared with 219 (40%) patients with non-caudate LM (P = 0.01). Patients with caudate LM were more likely to have intrahepatic disease as a component of recurrence (caudate: 51% vs. non-caudate: 25%; P = 0.001). No patient recurred on the vena cava or portal vein. Patients with caudate LM had shorter 5-year disease-free and overall survival than patients with non-caudate LM (disease-free: 24% vs. 44%; P = 0.02; overall: 41% vs. 58%; P = 0.02). Conclusions: Patients who undergo hepatic resection for caudate LM often present with multiple hepatic tumors and tumors in proximity to the major hepatic veins. Extended hepatectomy is required in the majority, although vascular resection is not frequently necessary; when performed, primary repair is usually possible. Despite resection in this population of patients with multiple and bilateral tumors, and despite close-margin and positive-margin resection in a significant proportion, recurrence on the portal vein or vena cava was not observed, and long-term survival is accomplished (41% 5-year overall survival). en_US
dc.language.iso en en_US
dc.title Resection of Hepatic Colorectal Metastases Involving the Caudate Lobe en_US
dc.type Article en_US
dc.description.version Published en_US
dc.title.subtitle Perioperative Outcome and Survival en_US
dc.author.school SOM en_US
dc.author.idnumber 201100945
dc.author.woa N/A en_US
dc.author.department N/A en_US
dc.description.embargo N/A en_US
dc.relation.journal Journal of Gastrointestinal Surgery en_US
dc.journal.volume 11 en_US
dc.journal.issue 1 en_US
dc.article.pages 66-72 en_US
dc.keywords Liver anatomy en_US
dc.keywords Hepatectomy en_US
dc.keywords Colorectal cancer en_US
dc.keywords Metastasis en_US
dc.identifier.doi http://dx.doi.org/10.1007/s11605-006-0045-3 en_US
dc.identifier.ctation Abdalla, E. K., Ribero, D., Pawlik, T. M., Zorzi, D., Curley, S. A., Muratore, A., ... & Vauthey, J. N. (2007). Resection of hepatic colorectal metastases involving the caudate lobe: perioperative outcome and survival. Journal of Gastrointestinal Surgery, 11(1), 66-72. en_US
dc.author.email eddie.abdalla@lau.edu.lb
dc.identifier.url http://link.springer.com/article/10.1007/s11605-006-0045-3

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