caa a22 4500 445336889 CHVBK 20180317142758.0 cr unu---uuuuu 170323e20110501xx s 000 0 eng 10.1245/s10434-010-1459-4 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1459-4 Liver Resection for Colorectal Metastases in Presence of Extrahepatic Disease: Results from an International Multi-institutional Analysis [Elektronische Daten] [Carlo Pulitanò, Martin Bodingbauer, Luca Aldrighetti, Mechteld de Jong, Federico Castillo, Richard Schulick, Rowan Parks, Michael Choti, Stephen Wigmore, Thomas Gruenberger, Timothy Pawlik] Background: Hepatic resection for colorectal liver metastasis (CLM) with concomitant extrahepatic disease (EHD) is a controversial topic. We sought to evaluate the long-term outcome of patients undergoing liver resection for CLM in presence of EHD and identify factors associated with prognosis. Methods: From 1996 to 2007, a total of 1629 patients who underwent resection of CLM were identified from an international multi-institutional database. One hundred seventy-one patients (10.4%) underwent resection of EHD. Clinicopathologic and outcome data were collected and analyzed by univariate and multivariate analyses. Results: Median number of treated CLM was 2 (range, 1-18); most patients had solitary EHD (n=114; 66.6%) a single anatomic site of EHD (n=153; 89.4%). The 5-year survival for patients with EHD was 26% compared with 58% for those without EHD (P<0.001). Recurrence was common (84%). Among patients with EHD, R1 margin status, multiple EHD sites, and location of EHD were associated with worse survival (all P<0.05). Patients with multiple EHD sites or aortocaval lymph node metastasis had a 5-year survival of 14% and 7%, respectively. When survival was stratified by the total number of metastases treated, the presence of EHD still had a prognostic impact, but the relative impact of EHD diminished as the total number of metastases treated increased. Conclusion: Concurrent resection of hepatic and EHD in well-selected patients may provide the possibility of long-term survival. The risk of recurrence, however, remains high, and a worse outcome is associated with both number of metastases and location of EHD. Society of Surgical Oncology, 2010 Pulitanò Carlo Department of Clinical and Surgical Sciences (Surgery), Royal Infirmary of Edinburgh, University of Edinburgh, Edinburgh, UK aut Bodingbauer Martin Department of General Surgery, Hepatobiliary Service, Medical University of Vienna, Vienna, Austria aut Aldrighetti Luca Department of Surgery, Liver Unit, Scientific Institute San Raffaele, Vita-Salute San Raffaele University, Milan, Italy aut de Jong Mechteld Division of Surgical Oncology, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA aut Castillo Federico Department of Clinical and Surgical Sciences (Surgery), Royal Infirmary of Edinburgh, University of Edinburgh, Edinburgh, UK aut Schulick Richard Division of Surgical Oncology, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA aut Parks Rowan Department of Clinical and Surgical Sciences (Surgery), Royal Infirmary of Edinburgh, University of Edinburgh, Edinburgh, UK aut Choti Michael Division of Surgical Oncology, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA aut Wigmore Stephen Department of Clinical and Surgical Sciences (Surgery), Royal Infirmary of Edinburgh, University of Edinburgh, Edinburgh, UK aut Gruenberger Thomas Department of General Surgery, Hepatobiliary Service, Medical University of Vienna, Vienna, Austria aut Pawlik Timothy Division of Surgical Oncology, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA aut Annals of Surgical Oncology Springer-Verlag 18/5(2011-05-01), 1380-1388 1068-9265 18:5<1380 2011 18 10434 https://doi.org/10.1245/s10434-010-1459-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1459-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Pulitanò Carlo Department of Clinical and Surgical Sciences (Surgery), Royal Infirmary of Edinburgh, University of Edinburgh, Edinburgh, UK aut NATIONALLICENCE 700 1- Bodingbauer Martin Department of General Surgery, Hepatobiliary Service, Medical University of Vienna, Vienna, Austria aut NATIONALLICENCE 700 1- Aldrighetti Luca Department of Surgery, Liver Unit, Scientific Institute San Raffaele, Vita-Salute San Raffaele University, Milan, Italy aut NATIONALLICENCE 700 1- de Jong Mechteld Division of Surgical Oncology, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA aut NATIONALLICENCE 700 1- Castillo Federico Department of Clinical and Surgical Sciences (Surgery), Royal Infirmary of Edinburgh, University of Edinburgh, Edinburgh, UK aut NATIONALLICENCE 700 1- Schulick Richard Division of Surgical Oncology, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA aut NATIONALLICENCE 700 1- Parks Rowan Department of Clinical and Surgical Sciences (Surgery), Royal Infirmary of Edinburgh, University of Edinburgh, Edinburgh, UK aut NATIONALLICENCE 700 1- Choti Michael Division of Surgical Oncology, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA aut NATIONALLICENCE 700 1- Wigmore Stephen Department of Clinical and Surgical Sciences (Surgery), Royal Infirmary of Edinburgh, University of Edinburgh, Edinburgh, UK aut NATIONALLICENCE 700 1- Gruenberger Thomas Department of General Surgery, Hepatobiliary Service, Medical University of Vienna, Vienna, Austria aut NATIONALLICENCE 700 1- Pawlik Timothy Division of Surgical Oncology, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/5(2011-05-01), 1380-1388 1068-9265 18:5<1380 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer