Impact of R1 resection for colorectal liver metastases on local recurrence in the era of modern chemotherapy. Analysis on 1428 resection areas

Abstract

Background: A character of hepatocellular carcinoma (HCC) is the thrombosis or tumor invasion of the portal vein (PV) and the inferior vena cava (IVC). The aim of this study was to search the Results of combined liver and vascular resections in the surgical treatment of HCC. Methods: The study included 90 patients with HCC who underwent radical resection of the liver. The patients with tumor lesions of the trunk, confluence or branches PV of the 1st order (20 pers.) were the group 1 and the patients with tumor lesion IVC (14 pers.) were the group 2. The control group consisted of 56 patients without tumor lesions of PV or IVC. Results: Patients in the control group carried out 32 major, 13 extended resections and 11 resections of two segments of the liver. Patients in Group 1 were made 13 large and 7 extended liver resections combined with resection of PV confluence. Patients in Group N 2 were made 9 and 5 major and extended resections of the liver, which in 7 cases were combined with the marginal resection and in 7 cases with resection of the IVC segment. The 3-and 5-year survival rates were 42,6% and 25,3% in the control group, 32,4% and 11,5 in the Group 1, 34,3% and 13,5% in the Group 2. Conclusion: Aggressive surgical approachliver resection combine with resection of portal vein and inferior vena cava is a safe procedure with acceptable morbidity, mortality and long term survival.