Resection of the liver for colorectal carcinoma XXXX . A multi-institutional study of long-term survivors.

@entity1 @entity189 @entity3
In this review of a collected series of @entity1 undergoing hepatic resection for colorectal @entity3 , 100 @entity1 were found to have survived greater than five years from the time of resection. Of these 100 long-term survivors, 71 remain disease-free through the last follow-up, 19 recurred prior to five years, and ten recurred after five years. @entity1 characteristics that may have contributed to survival were examined. Procedures performed included five trisegmentectomies, 32 lobectomies, 16 left lateral segmentectomies, and 45 wedge resections. The margin of resection was recorded in 27 @entity1 , one of whom had a positive margin, nine of whom had a less than or equal to 1-cm margin, and 17 of whom had a greater than 1-cm margin. Eighty-one @entity1 had a solitary metastasis to the liver, 11 @entity1 had two @entity3 , one @entity1 had three @entity3 , and four @entity1 had four @entity3 . Thirty @entity1 had Stage C @entity189 , 40 had Stage B @entity189 , and one had Stage A @entity189 . The disease-free interval from the time of colon resection to the time of liver resection was less than one year in 65 @entity1 , and greater than one year in 34 @entity1 . Three @entity1 had bilobar @entity3 . Four of the @entity1 had extrahepatic disease resected simultaneously with the liver resection. Though several contraindications to hepatic resection have been proposed in the past, five-year survival has been found in @entity1 with extrahepatic disease resected simultaneously, @entity1 with bilobar @entity3 , @entity1 with multiple @entity3 , and @entity1 with positive margins. Five-year disease-free survivors are also present in each of these subsets. It is concluded that five-year survival is possible in the presence of reported contraindications to resection, and therefore that the decision to resect the liver must be individualized.
