| International Session (Symposium) 7 (JSGS・JSGE・JSH) |
| Sat. November 3rd 14:00 - 17:00 Room 4: Portopia Hotel South Wing Portopia Hall |
| Outcomes of hepatic resection and/or microwave coagulo-necrotic therapy for marginally resectable multiple colorectal liver metastasis | |||
| Takanobu Hara1, Yuko Takami1, Hideki Saitsu1 | |||
| 1Department of Hepato-Biliary-Pancreatic Surgery, National Hospital Organization Kyushu Medical Center | |||
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| Backgrounds: Microwave coagulo-necrotic therapy (MCN) is an alternative of staged approaches to hepatic resection (Hr) for marginally or unresectable colorectal liver metastasis (CRLM), which enable local control of tumors without the limitation of tumor numbers and future liver remnant. We evaluated the efficacy of Hr and/or MCN for marginally resectable CRLM (≥5 lesions, mrCRLM) Methods: Seventy-nine mrCRLM patients who underwent Hr and/or MCN from 2005 to 2016 were reviewed. OS, DFS, and local recurrence rate of MCN were analyzed. Results: The median tumor diameter was 2.3 cm (0.9-9.5) and number of tumor was 9 (5-45). Three patients underwent Hr, 30 underwent MCN, and 46 underwent Hr + MCN. Though 2-year DFS was 8.0% and 2-year liver related DFS was 19.8%, respectively, reasonable 5-year OS (45.2%) and median survival (53.9 months) was observed. DFS in patients with more than 10 tumors were significantly worse (p <0.01) but OS was similar. Preoperative chemotherapy was not a prognostic factor for both in OS and DFS. Adjuvant chemotherapy was an independent prognostic factor for DFS (p <0.01), but not for OS. Local recurrence after MCN was found in 26 of 729 tumors (3.6%). Of these, 8 tumors were close to hepatic vein trunk or inferior vena cava, 3 were close to Glisson capsule, 3 were ≥3 cm in diameter, and 11 were located in segment 7 with deep puncture. However, local recurrence was not an independent prognostic factor for OS and DFS. Conclusion: Though MCN has limitations such as treatable tumor size or tumor location that increase risk of local recurrence, Hr and/or MCN for mrCRLM was found to be effective in appropriate patients. |
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Index Term 1: liver metastases Index Term 2: colorectal cancer |
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