Staged hepatectomy for bilobar colorectal hepatic metastases

Abstract

In patients in whom staged resection for bilobar CRLM is feasible, surgery would appear to offer benefit.

Can we improve the clinical risk score? The prognostic value of p53, Ki-67 and thymidylate synthase in patients undergoing radical resection of colorectal liver metastases

“…Although all patients underwent a potentially curative resection, 73% of them subsequently developed recurrent disease. Reported 5‐year OS data in some modern series reaches 60% in selected patients . However, the current study presents actual rather than actuarial survival data.…”

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in colorectal liver metastasis: the radiologist’s perspective

“…Following PVO in a patient with bilateral liver metastasis, the risk of tumor progression is increased in the FLR, which results in an overall 52%-80% resection rate for traditional two-stage hepatectomy [26].…”

Staged resection of bilobar colorectal liver metastases: surgical strategies

“…Univariate analysis showed that age over 70 years, male gender, larger lesions >5 cm, serum carcinoembryonic antigen level before PVE greater than 200 ng/ml, and three or more metastases in the FRL were significant factors predicting failure to achieve two-stage hepatectomy (TSH). Multivariable logistic regression analysis showed the presence of extrahepatic disease, three or more metastases in the FRL, and patient age above 70 years to be factors associated with the failure of staged resection [26,27]. The main reasons for the non-completion of the second stage are tumor progression, followed by insufficient hypertrophy of the remnant liver and portal vein thrombosis of FLR.…”