Effects of the proximity of metastasis to the central vessels of the liver on surgical outcomes and survival in colorectal cancer with liver metastasis

Jun Woo Bong, Yeonuk Ju, Jihyun Seo, Sang Hee Kang, Pyoung Jae Park, Sae Byeol Choi, Sun Il Lee, Sang Cheul Oh, Byung Wook Min

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Resectability of liver metastasis is important to establish a treatment strategy for patients with colorectal cancer. We aimed to evaluate the effect of the distance from metastasis to the centre of the liver on surgical outcomes and survival after hepatectomy. Methods: The clinical data of a total of 155 patients who underwent hepatectomy for colorectal cancer with liver metastasis were retrospectively reviewed. We measured the minimal length from metastasis to the bifurcation of the portal vein at the primary branch of the Glissonean tree and defined it as ‘centrality’. The postoperative outcomes and survival among the patients were then analysed. Results: Anatomic resections were more frequently performed, and the operative time was longer in the patients with high centrality (≤1.5 cm) than in the patients with low centrality (>1.5 cm). A size of ≥5 cm for the largest lesion, a number of lesions of ≥3 and centrality of ≤1.5 cm were found to be the independent risk factors of a positive resection margin after hepatectomy. The patients with high centrality showed worse recurrence-free survival than those with low centrality; however, there was no significant difference found in the overall survival. In the multivariate analysis, high centrality was not found to be associated with worse recurrence-free and overall survival. Conclusion: Centrality significantly affected the surgical outcomes and treatment strategy for liver metastasis but did not influence the survival of the patients with colorectal cancer. Active efforts through surgical resections are important to treat liver metastasis of high centrality.

Original languageEnglish
Pages (from-to)E183-E189
JournalANZ Journal of Surgery
Volume91
Issue number4
DOIs
Publication statusPublished - 2021 Apr
Externally publishedYes

Keywords

  • colorectal cancer
  • liver metastasis
  • resectability

ASJC Scopus subject areas

  • Surgery

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