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Titolo:
Simultaneous detection of colorectal carcinoma liver and lung metastases does not warrant resection
Autore:
Nagakura, S; Shirai, Y; Yamato, Y; Yokoyama, N; Suda, T; Hatakeyama, K;
Indirizzi:
Niigata Univ, Sch Med, Dept Surg, Niigata 9518510, Japan Niigata Univ Niigata Japan 9518510 ed, Dept Surg, Niigata 9518510, Japan Niigata Univ, Sch Med, Dept Thorac & Cardiovasc Surg, Niigata 9518510, Japan Niigata Univ Niigata Japan 9518510 rdiovasc Surg, Niigata 9518510, Japan
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS
fascicolo: 2, volume: 193, anno: 2001,
pagine: 153 - 160
SICI:
1072-7515(200108)193:2<153:SDOCCL>2.0.ZU;2-U
Fonte:
ISI
Lingua:
ENG
Soggetto:
PROGNOSTIC SCORING SYSTEM; PULMONARY METASTASES; HEPATIC RESECTION; REPEAT HEPATECTOMY; SURGICAL-TREATMENT; CANCER;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: Shirai, Y Niigata Univ, Sch Med, Dept Surg, 1-757 Asahimachi Dori, Niigata9518510, Japan Niigata Univ 1-757 Asahimachi Dori Niigata Japan 9518510 Japan
Citazione:
S. Nagakura et al., "Simultaneous detection of colorectal carcinoma liver and lung metastases does not warrant resection", J AM COLL S, 193(2), 2001, pp. 153-160

Abstract

BACKGROUND: Recent evidence suggests that metastasectomy is efficacious for selected patients with hepatic and pulmonary metastases from a colorectalprimary. The aim of this study was to identify a subgroup of patients who best benefit from hepatic and pulmonary metastasectomy among those with colorectal carcinoma metastases. STUDY DESIGN: We analyzed retrospectively a total of 136 patients who underwent resection of hepatic or pulmonary metastases of colorectal origin at Niigata University Medical Hospital between 1982 and 2000. The median followup period was 94 months. Eighty-four patients underwent hepatectomy alone,25 underwent pulmonary resection alone, and 27 underwent both hepatic and pulmonary resection. The 27 patients undergoing hepatic and pulmonary resection were divided into two groups: 17 patients with sequentially detected hepatic and pulmonary metastases and 10 patients with simultaneously detected metastases. Survival time was determined from the date of initial metastasectomy. Differences in cumulative survival were evaluated using the log-rank test. Sixteen factors were assessed for their influence on the survival of the 27 patients undergoing resection of hepatic and pulmonary metastases; univariate and multivariate analyses were used in this evaluation. RESULTS: Patient survival after hepatic and pulmonary resection was comparable with that after hepatectomy alone (P = 0.536) and that after pulmonaryresection alone (p = 0.294). Among the 27 patients undergoing hepatic and pulmonary resection, the outcomes after resection were significantly betterin patients with sequentially detected metastases (cumulative 5-year survival of 44%) than in those with simultaneously detected ones (cumulative 5-year survival of 0%) (p < 0.001). On multivariate analysis sequential detection of hepatic and pulmonary metastases was the strongest independent favorable prognostic factor (p < 0.001). CONCLUSIONS: Patients with sequentially detected hepatic and pulmonary metastases from a colorectal primary are good candidates for aggressive metastasectomy. Simultaneous detection of these metastases does not warrant resection. (J Am Coll Surg 2001;193:153-160. (C) 2001 by the American College ofSurgeons).

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/07/20 alle ore 22:58:29