caa a22 4500 445334142 CHVBK 20180317142747.0 cr unu---uuuuu 170323e20110701xx s 000 0 eng 10.1245/s10434-010-1533-y doi (NATIONALLICENCE)springer-10.1245/s10434-010-1533-y Two-Stage Resection for Bilobar Colorectal Liver Metastases: R0 Resection Is the Key [Elektronische Daten] [Nicole Tsim, Andrew Healey, Adam Frampton, Nagy Habib, Devinder Bansi, Harpreet Wasan, Susan Cleator, Justin Stebbing, Charles Lowdell, James Jackson, Paul Tait, Long Jiao] Background: Two-stage liver resection (2-SLR) is used clinically in conjunction with portal vein embolization for bilobar disease to increase the number of patients suitable for liver resection. The long-term outcomes after 2-SLR for multiple bilobar colorectal liver metastases (CLM) was examined. Methods: Patients who sought care between November 2003 and April 2006 with multiple CLM considered suitable for 2-SLR were prospectively followed. Clinicopathological data were collected. Surgical outcomes were defined as complete clearance of tumor (R0/R1/R2), postoperative morbidity (within 3months), 30day mortality, disease-free survival (DFS), and overall survival (OS). Results: A total of 131 patients with CLM underwent liver resection during the study period, 38 of whom were planned for a 2-SLR for multiple bilobar disease. Only 33 (87%) completed the 2-SLR with a curative intent. Five patients did not undergo stage II resection because of disease progression. The postoperative morbidity was 11 and 33% after stage I and stage II liver resections, respectively. Five patients (13%) encountered postoperative complications specific to liver surgery. The median interval from stage II resection to disease recurrence in the R0 group was 18months versus 3months in the R1/R2 group (P<0.001). R0 resection with curative intent versus R1/R2 noncurative resection has a significantly longer period of DFS (P<0.001) and OS (P=0.04). Conclusions: The 2-SLR combined with portal vein embolization is an effective and safe method for resecting previously unresectable multiple bilobar CLM. However, a positive resection margin leads to poor DFS and OS. Society of Surgical Oncology, 2011 Tsim Nicole Department of Surgery and Cancer, HPB Surgical Unit, Imperial College, Hammersmith Hospital Campus, London, UK aut Healey Andrew Department of Surgery and Cancer, HPB Surgical Unit, Imperial College, Hammersmith Hospital Campus, London, UK aut Frampton Adam Department of Surgery and Cancer, HPB Surgical Unit, Imperial College, Hammersmith Hospital Campus, London, UK aut Habib Nagy Department of Surgery and Cancer, HPB Surgical Unit, Imperial College, Hammersmith Hospital Campus, London, UK aut Bansi Devinder Department of Gastroenterology, Imperial College NHS Trust, Hammersmith Hospital, London, UK aut Wasan Harpreet Department of Oncology, Imperial College, Hammersmith Hospital Campus, London, UK aut Cleator Susan Department of Oncology, Imperial College, Hammersmith Hospital Campus, London, UK aut Stebbing Justin Department of Oncology, Imperial College, Hammersmith Hospital Campus, London, UK aut Lowdell Charles Department of Oncology, Imperial College, Hammersmith Hospital Campus, London, UK aut Jackson James Department of Radiology, Imperial College NHS Trust, Hammersmith Hospital, London, UK aut Tait Paul Department of Radiology, Imperial College NHS Trust, Hammersmith Hospital, London, UK aut Jiao Long Department of Surgery and Cancer, HPB Surgical Unit, Imperial College, Hammersmith Hospital Campus, London, UK aut Annals of Surgical Oncology Springer-Verlag 18/7(2011-07-01), 1939-1946 1068-9265 18:7<1939 2011 18 10434 https://doi.org/10.1245/s10434-010-1533-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1533-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Tsim Nicole Department of Surgery and Cancer, HPB Surgical Unit, Imperial College, Hammersmith Hospital Campus, London, UK aut NATIONALLICENCE 700 1- Healey Andrew Department of Surgery and Cancer, HPB Surgical Unit, Imperial College, Hammersmith Hospital Campus, London, UK aut NATIONALLICENCE 700 1- Frampton Adam Department of Surgery and Cancer, HPB Surgical Unit, Imperial College, Hammersmith Hospital Campus, London, UK aut NATIONALLICENCE 700 1- Habib Nagy Department of Surgery and Cancer, HPB Surgical Unit, Imperial College, Hammersmith Hospital Campus, London, UK aut NATIONALLICENCE 700 1- Bansi Devinder Department of Gastroenterology, Imperial College NHS Trust, Hammersmith Hospital, London, UK aut NATIONALLICENCE 700 1- Wasan Harpreet Department of Oncology, Imperial College, Hammersmith Hospital Campus, London, UK aut NATIONALLICENCE 700 1- Cleator Susan Department of Oncology, Imperial College, Hammersmith Hospital Campus, London, UK aut NATIONALLICENCE 700 1- Stebbing Justin Department of Oncology, Imperial College, Hammersmith Hospital Campus, London, UK aut NATIONALLICENCE 700 1- Lowdell Charles Department of Oncology, Imperial College, Hammersmith Hospital Campus, London, UK aut NATIONALLICENCE 700 1- Jackson James Department of Radiology, Imperial College NHS Trust, Hammersmith Hospital, London, UK aut NATIONALLICENCE 700 1- Tait Paul Department of Radiology, Imperial College NHS Trust, Hammersmith Hospital, London, UK aut NATIONALLICENCE 700 1- Jiao Long Department of Surgery and Cancer, HPB Surgical Unit, Imperial College, Hammersmith Hospital Campus, London, UK aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/7(2011-07-01), 1939-1946 1068-9265 18:7<1939 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer