No abstract

While 5-year survival following surgery for colorectal liver metastasis approaches 50%, over one-half of patients develop recurrence within 2 years. The pattern of failure is distributed relatively equally among intrahepatic, extrahepatic, and intra- plus extrahepatic sites. Patients undergoing repeat surgery for recurrent metastasis have similar patterns of recurrence and RFS time.

H epatic resection and liver transplantation are aggressive, extirpative approaches to the treatment of selected patients for hepatocellular carcinoma (HCC) and are the only known potentially curative treatment options for this disease. Resection and transplantation are largely complimentary, not competing, treatments-resection for patients with preserved liver function and transplantation for patients with compromised liver function. Within each group, selection of patients for surgical therapy is currently based on morphologic criteria such as size, number of tumors, and degree of underlying liver disease.After resection, long-term survival can be expected in patients with solitary tumors regardless of size, especially when underlying fibrosis is minimal. 1 In fact, size has no significant impact on survival when microscopic vascular invasion is absent, as survival after resection of T1 tumors larger than 10 cm in diameter is similar to survival following resection of T1 tumors less than 5 cm. 1 Similarly, long-term survival can be expected when multiple tumors without vascular invasion are completely resected. 1 The establishment of strict morphologic criteria has significantly impacted the outcome after liver transplantation for HCC. Before the adoption of these criteria for transplantation, results with liver transplantation were poor. Recurrence rates ranged from 60% to 70%, 2,3 and the 5-year survival rate was less than 30%. 4,5 Since the implementation of more stringent selection criteria, survival rates after liver transplantation have been similar to those after resection for Abbreviations: HCC, hepatocellular carcinoma; AFP, alpha-fetoprotein; HR, hazard ratio; FNA, fine-needle aspiration.

Sarcopenia impacts short-, but not long-term outcomes after resection of CRLM. While patients with sarcopenia are at an increased risk of post-operative morbidity and longer hospital stay, long-term survival is not impacted by the presence of sarcopenia.