caa a22 4500 445335815 CHVBK 20180317142754.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1245/s10434-010-1418-0 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1418-0 Is Delayed Liver Resection Appropriate for Patients with Metachronous Colorectal Metastases? [Elektronische Daten] [Shinichi Ueno, Masahiko Sakoda, Masaki Kitazono, Satoshi Iino, Hiroshi Kurahara, Koji Minami, Kei Ando, Yukou Mataki, Kosei Maemura, Sumiya Ishigami, Shoji Natsugoe] Background: In terms of timing of resection for synchronous liver metastases from colon cancer, some reports recommend leaving an interval (e.g., 3months) after primary colorectal resection, because of reports of occasional and rapid remnant recurrence of residual liver metastases after simultaneous colorectal and liver resection (LR). For patients with metachronous liver metastasis (MLM), we prospectively examined the appropriateness of a 3-month interval to LR (i.e., delayed resection) following initial detection of hepatic lesions from the viewpoints of (1) detection of new metastases during this interval and (2) postoperative outcome. Methods: Seventy-nine consecutive patients with modified Japanese criteria H1 class MLM (i.e., ≤4 nodules, 6cm or less in diameter) and without obvious extrahepatic lesions, presenting between 1990 and 2008, were included in this study. Between 1990 and 2001, 52 patients were treated by LR without an interval (i.e., nondelayed group); from 2002, 27 patients were prospectively scheduled for LR at an interval of 3months after initial detection of metastases (i.e., delayed group). During the 3-month interval, no adjuvant chemotherapy was given. Just prior to LR, patients were re-evaluated using computed tomography (CT) and deoxy-2-[18F]fluoro-d-glucose positron emission tomography (FDG-PET) to exclude cases unsuitable for surgery. Results: Out of 27 patients in the delayed group, 2 (7.4%) did not undergo LR after the 3-month interval and were excluded from the analysis: one because of multiple nodules in the bilateral lobe of the liver with pulmonary metastases and another because of para-aortic lymph node metastasis. Of the 25 patients for whom LR was indicated, 24 underwent LR as initially planned. In the remaining patient, after the 3-month interval, invasion of the tumor had occurred into the inferior vena cava (IVC) and other surgery in addition to the planned operation was required. When comparing the postoperative outcome data of the delayed group (n=25) with the nondelayed group (n=52), overall early recurrence within 1year after LR was noticed in 30.9% (16/52) of the nondelayed group and 28.0% (7/25) of the delayed group; the incidence of only early extrahepatic recurrence decreased 5.1% in the delayed group (21.1% versus 16.0%, respectively). When comparing disease-free survival after liver resection, however, there was no significant difference between the groups. Conclusions: Delayed LR for MLM patients after initial detection of hepatic lesions is of no clinical benefit. Only in cases when extrahepatic lesions with MLM are suspected could an interval make such lesions clearer and assist in deciding on a suitable management plan. Society of Surgical Oncology, 2010 Ueno Shinichi Department of Surgical Oncology & Digestive Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medicine & Dental Sciences, Kagoshima, Japan aut Sakoda Masahiko Department of Surgical Oncology & Digestive Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medicine & Dental Sciences, Kagoshima, Japan aut Kitazono Masaki Department of Surgical Oncology & Digestive Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medicine & Dental Sciences, Kagoshima, Japan aut Iino Satoshi Department of Surgical Oncology & Digestive Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medicine & Dental Sciences, Kagoshima, Japan aut Kurahara Hiroshi Department of Surgical Oncology & Digestive Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medicine & Dental Sciences, Kagoshima, Japan aut Minami Koji Department of Surgical Oncology & Digestive Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medicine & Dental Sciences, Kagoshima, Japan aut Ando Kei Department of Surgical Oncology & Digestive Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medicine & Dental Sciences, Kagoshima, Japan aut Mataki Yukou Department of Surgical Oncology & Digestive Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medicine & Dental Sciences, Kagoshima, Japan aut Maemura Kosei Department of Surgical Oncology & Digestive Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medicine & Dental Sciences, Kagoshima, Japan aut Ishigami Sumiya Department of Surgical Oncology & Digestive Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medicine & Dental Sciences, Kagoshima, Japan aut Natsugoe Shoji Department of Surgical Oncology & Digestive Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medicine & Dental Sciences, Kagoshima, Japan aut Annals of Surgical Oncology Springer-Verlag 18/4(2011-04-01), 1104-1109 1068-9265 18:4<1104 2011 18 10434 https://doi.org/10.1245/s10434-010-1418-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1418-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ueno Shinichi Department of Surgical Oncology & Digestive Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medicine & Dental Sciences, Kagoshima, Japan aut NATIONALLICENCE 700 1- Sakoda Masahiko Department of Surgical Oncology & Digestive Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medicine & Dental Sciences, Kagoshima, Japan aut NATIONALLICENCE 700 1- Kitazono Masaki Department of Surgical Oncology & Digestive Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medicine & Dental Sciences, Kagoshima, Japan aut NATIONALLICENCE 700 1- Iino Satoshi Department of Surgical Oncology & Digestive Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medicine & Dental Sciences, Kagoshima, Japan aut NATIONALLICENCE 700 1- Kurahara Hiroshi Department of Surgical Oncology & Digestive Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medicine & Dental Sciences, Kagoshima, Japan aut NATIONALLICENCE 700 1- Minami Koji Department of Surgical Oncology & Digestive Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medicine & Dental Sciences, Kagoshima, Japan aut NATIONALLICENCE 700 1- Ando Kei Department of Surgical Oncology & Digestive Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medicine & Dental Sciences, Kagoshima, Japan aut NATIONALLICENCE 700 1- Mataki Yukou Department of Surgical Oncology & Digestive Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medicine & Dental Sciences, Kagoshima, Japan aut NATIONALLICENCE 700 1- Maemura Kosei Department of Surgical Oncology & Digestive Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medicine & Dental Sciences, Kagoshima, Japan aut NATIONALLICENCE 700 1- Ishigami Sumiya Department of Surgical Oncology & Digestive Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medicine & Dental Sciences, Kagoshima, Japan aut NATIONALLICENCE 700 1- Natsugoe Shoji Department of Surgical Oncology & Digestive Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medicine & Dental Sciences, Kagoshima, Japan aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/4(2011-04-01), 1104-1109 1068-9265 18:4<1104 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer