Biomedical subjects

Seigo Kitano

Publications and source records attributed to Seigo Kitano.

At least 109 records · Page 6Linked to original sources

PubMedDate not supplied

Hepatectomy for liver metastasis from ampullary cancer after pancreatoduodenectomy.

A 51-year-old Japanese woman with a solitary liver metastasis originating from a carcinoma of the ampulla of Vater was successfully treated by partial hepatectomy 19 months after curative pancreatoduodenectomy with lymphadenectomy. Histologic examination revealed a stage III well-differentiated tubular adenocarcinoma (pT2, pN1, and pM0). Postoperative serum concentrations of carcinoembryonic antigen increased exponentially to 133 ng/mL. The carcinoembryonic antigen doubling time was 63 days. Computed tomography and ultrasonography of the abdomen showed a solitary metastasis in segment VI of the liver. Since neither local recurrences nor other distant metastases were detected, the patient underwent partial hepatectomy. Histologic study confirmed the presence of a metastatic liver tumor from the ampullary carcinoma. The carcinoembryonic antigen levels returned to normal immediately after the partial hepatectomy. She was well without signs of recurrence 18 months after partial hepatectomy.

Adenocarcinoma↗

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Pancreatic resection with ultrasonically activated scalpel: preliminary observations.

BACKGROUND/AIMS: Resection of the pancreas was performed with a surgical knife, electrocautery, or an automatic stapler. We histologically and radiologically evaluated the applicability of the ultrasonically activated scalpel (Coagulating Shears, CS, Ethicon Endo-Surgery, Cincinnati, OH, USA) for resecting pancreatic parenchyma and reported our clinical observations on the use of the coagulating shears. METHODOLOGY: Resection of the pancreas was performed with the coagulating shears in 8 patients and with electrocautery in 5. The pancreas was transected with blunt mode of the coagulating shears at output power level of 3. Histologic thermal degeneration of the surface was evaluated with hematoxylin-eosin and Azan-Mallory staining. Radiologic pancreaticography was carried out on 4 resected specimens. We report 8 practical applications of the coagulating shears and compared its use with that of electrocautery in pancreatic surgery. RESULTS: Histologically, a coagulum of degenerated tissue completely closed each end of the vessels in the transected surface of all cases. The mean breadth of thermal degeneration resulting from the use of the coagulating shears was significantly less than that caused by electrocautery (1.33 +/- 0.21 vs. 3.05 +/- 0.34 mm, respectively) Pancreaticograms showed the closed branches of the pancreatic duct, but the closed main pancreatic duct had burst in 1 of 4 cases. Clinically, pancreatic fistula occurred in 1 of 8 patients who underwent pancreatic surgery with the coagulating shears. CONCLUSIONS: Pancreatic resection with the coagulating shears might be effective and feasible as long as the main pancreatic duct is ligated.

Aged↗

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Staging with helical computed tomography and laparoscopy in pancreatic head cancer.

BACKGROUND/AIMS: Helical computed tomography provides valuable information about extent of pancreatic cancer. However, it remains difficult to detect small distant metastases. Laparoscopic examination is becoming standard for cancer staging. METHODOLOGY: Between 1995 and 1999, 45 patients with radiologically resectable pancreatic head cancer were analyzed retrospectively to clarify the indications for and role of staging laparoscopy. Computed tomography was examined for tumor size and spread to portal or superior mesenteric veins (PV) and celiac or superior mesenteric arteries (A). RESULTS: There were 29 (64%) patients with resectable disease, 4 (9%) with localized unresectable, and 12 (27%) with metastatic (hepatic in 7 and peritoneal in 5). Patients with metastatic disease were more likely to present with abdominal pain, vomiting, and back pain than were patients with resectable disease (p < 0.05). The mean tumor size and involvement of PV or A were greater in metastatic patients than in resectable patients (p < 0.005 or p < 0.01). The survival rate for patients with metastatic disease was lower than that for patients with resectable disease (p < 0.0001). CONCLUSIONS: According to clinical features and computed tomography findings, laparoscopic exploration is recommended for cancer staging. Helical computed tomography and staging laparoscopy categorize patients into those with localized and those with metastatic disease which considerably correlated with survivals.

Adenocarcinoma↗

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Indications for pylorus-preserving gastrectomy for gastric cancer based on lymph node metastasis.

BACKGROUND/AIMS: It is necessary to study the relation between lymph node metastasis in the suprapyloric or lesser curvature regions and clinicopathologic findings in order to determine the indications for pylorus-preserving gastrectomy. METHODOLOGY: We reviewed all pertinent data from the cases of 109 patients with gastric cancer located mainly in the middle third of the stomach focusing particularly on status of lymph node metastasis and clinicopathologic findings. All patients had been treated by conventional gastrectomy with regional lymph node dissection (D2 or D3). RESULTS: Lymph node metastases were found in the lesser curvature or suprapyloric regions in 18 patients. Primary tumors were located in the lesser curvature side in 15 of these 18 patients and in the greater curvature side in only 3. Primary tumors in the greater curvature side with involvement in the lesser curvature or suprapyloric lymph nodes were greater than 4.0 cm in diameter, whereas primary tumors in the lesser curvature side with such metastasis were greater than 1.3 cm. CONCLUSIONS: Indications for pylorus-preserving gastrectomy with preserving of the pyloric branch of the vagal nerve perhaps can be expanded to middle stomach cancer located in the greater curvature side that is less than 4.0 cm in diameter.

Adenocarcinoma↗

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Pancreatic arteriovenous malformation treated by transcatheter embolization.

Arteriovenous malformation of the pancreas is a rare condition that may cause upper gastrointestinal bleeding. A 58-year-old man with an arteriovenous malformation of the pancreas is described. The patient had recurrent episodes of melena. The diagnosis was confirmed by angiographic study and color Doppler ultrasonography. Therapeutic embolization of the arteriovenous malformation was successfully carried out. In conclusion, transcatheter arterial embolization should be chosen for the patient with the pancreatic arteriovenous malformation.

Angiography↗

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Lymphatic spread differs according to tumor location in extrahepatic bile duct cancer.

BACKGROUND/AIMS: Identification of nodal involvement according to primary tumor location in extrahepatic bile duct carcinoma may guide surgical therapy. METHODOLOGY: Pathologic data of 81 patients who underwent curative operation for bile duct carcinoma were studied to clarify the differences in lymphatic spread from distal bile duct carcinoma, middle bile duct carcinoma, and proximal bile duct carcinoma. RESULTS: Lymph node metastases were present in 25 of 41 patients (61%) with distal bile duct carcinoma, 9 of 19 (47%) with middle bile duct carcinoma, and 11 of 21 (52%) with proximal bile duct carcinoma. The number of positive nodes per node-positive patient was greater in patients with middle bile duct carcinoma than in those with distal- or proximal bile duct carcinoma (mean 5.33 vs. 3.56 or 2.64, p < 0.05). Lymph nodes in the hepatoduodenal ligament were most frequently involved regardless of the primary tumor location. The frequency of distal- and middle bile duct carcinoma patients with metastasis to the superior mesenteric or para-aortic nodes was significantly higher than that of proximal bile duct carcinoma patients (p < 0.05 and p < 0.05). CONCLUSIONS: Patterns of lymphatic spread were different according to primary tumor location in bile duct carcinoma. Metastatic nodes were spread widely, from the hepatoduodenal ligament or posterior pancreaticoduodenal region to the nodes around the superior mesenteric artery and abdominal aorta, in distal- and middle bile duct carcinoma.

Adult↗

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Clinical significance of combined pancreas and portal vein resection in surgery for pancreatic adenocarcinoma.

BACKGROUND/AIMS: Surgical resection remains the only potentially curative treatment for pancreatic adenocarcinoma for which the resectability and prognosis are still poor. The aim of the present study was to evaluate the efficacy of portal vein resection for pancreatic adenocarcinoma. METHODOLOGY: Between August 1983 and December 2000, 69 patients with pancreatic ductal cell carcinoma underwent resection in our department; 22 of the 69 had combined resection of the pancreas and portal vein. When the pancreas could not be separated from the portal vein, the vein was judged to be invaded by cancer and resected. RESULTS: The mortality rate for portal vein resection was 4.5%, which was similar to that in 47 patients with no resection of the portal vein (2.1%). Postoperative histologic analysis showed that 8 (37%) of the patients who underwent portal vein resection did not have cancer invasion to the portal vein, and 3 of them remain disease free to date. The 3-year survival rate of patients undergoing portal vein resection was 21.3%, and that of patients without portal vein resection was 20.0%. CONCLUSIONS: Resection of the portal vein in cases of pancreatic ductal cell carcinoma has no adverse affect on long-term survival for selected patients.

Adult↗

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Gastric remnant cancer compared with primary proximal gastric cancer.

BACKGROUND/AIMS: Recently, detections of early-stage gastric remnant cancer and small proximal gastric cancer are increasing. The aim of this study was to compare pathologic and prognostic data of gastric remnant cancer with those of primary proximal gastric cancer including upper gastric cancer based on a recent 15-year experience at a single institute in Japan. METHODOLOGY: Among 698 patients who underwent gastrectomy for cancer between 1984 and 1998, 15 (2.1%) were patients with gastric remnant cancer. During the same period, 139 patients underwent primary gastrectomy for proximal gastric cancer which included 71 with upper gastric cancer confined to the upper one-third of the stomach. Clinicopathologic findings of gastric remnant cancer were compared with those of proximal gastric cancer. RESULTS: Of 15 gastric remnant cancers, 8 (53%) were stage I tumors. Although gastric remnant cancer and proximal gastric cancer was not different in several clinicopathologic factors, gastric remnant cancer and upper gastric cancer confined to the upper one-third of the stomach was different with regard to the frequency of tumor size > or = 4 cm (60% vs. 32%, p < 0.05), poorly differentiated type (67% vs. 38%, p < 0.05), serosal invasion (40% vs. 11%, p < 0.01), lymph node metastasis (47% vs. 20%, p < 0.05), stage III or IV disease (47% vs. 10%, p < 0.01), and noncurative gastrectomy (20% vs. 1%, p < 0.01). The 5-year survival rate of gastric remnant cancer (69%) was higher than that of proximal gastric cancer (57%) and lower than that of upper gastric cancer (81%), although the differences were not statistically significant. CONCLUSIONS: In our recent series, a half of gastric remnant cancers are stage I tumors. Although gastric remnant cancers are similar to proximal gastric cancers, they are more advanced and their surgical results are less satisfactory when compared with upper gastric cancers confined to the upper one-third of the stomach.

Adenocarcinoma↗

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Quality of life after laparoscopic or open colonic resection for cancer.

BACKGROUND/AIMS: Although laparoscopic colectomy has been widely accepted, little is known about the subjective clinical results of this less invasive surgery. The aim of this study was to evaluate the quality of life of patients who had undergone laparoscopic or open colonic resection for cancer. METHODOLOGY: The study included 26 patients with laparoscopic colectomy and 87 with conventional open colectomy for cure of colon cancer. Body temperature, serum C-reactive protein and albumin levels, lymphocyte count, and weight loss during hospital stay were compared between the two groups. Quality of life was estimated by the 9-item questionnaire with scoring system of 1 (high), 2 (fair), and 3 (low). RESULTS: Laparoscopic colectomy was significantly different from open colectomy with regard to the body temperature (37.8 degrees C vs. 38.0 degrees C, p < 0.01) and C-reactive protein level (6.34 mg/dL vs. 11.15 mg/dL, p < 0.01) on postoperative day 1, albumin level (3.54 g/dL vs. 3.36 g/dL, p < 0.05) and lymphocyte count (1354/mm3 vs. 995/mm3, p < 0.01) on postoperative day 7, and weight loss on postoperative day 14 (3.95% vs. 5.45%, p < 0.01). Although all patients with laparoscopic colectomy were satisfied with their surgical results, total score of the quality-of-life questionnaire was not significantly different between the two groups (10.95 vs. 11.81). Both laparoscopic and open colonic resections were similarly accepted by the patients as a good operation that they would recommend to others (1.105 vs. 1.206). CONCLUSIONS: These results indicate that although laparoscopic colonic resection for cancer was less invasive than conventional open colectomy, both laparoscopic and open colonic resections were favorably accepted by the patients, and quality of life after operation was not significantly different between the two procedures.

Colectomy↗

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Surgical technique influences bowel function after low anterior resection and sigmoid colectomy.

BACKGROUND/AIMS: Since June 1996, we have changed surgical strategies to preserve the pelvic autonomic nerve and abandon high ligation of the inferior mesenteric artery. The aim of this study was to clarify the influence of this surgical technique on subjective bowel function of patients with low anterior resection and sigmoid colectomy for cancer. METHODOLOGY: Forty-eight patients who underwent low anterior resection or sigmoid colectomy for cancer during June 1996 and February 2000 replied to the questionnaire which consisted of eight categories of bowel symptoms. Subjective bowel function and operative data of these patients were compared with those obtained from 84 patients with low anterior resection or sigmoid colectomy during April 1984 and May 1996. RESULTS: When recent series were compared with previous series, the frequency of bowel movement at night (21% vs. 60%, p < 0.01) and patient's own judgment as fair or poor (0% vs. 29%, p < 0.01) was decreased in patients with low anterior resection; whereas the frequency of defecation > 2 per day (5% vs. 34%, p < 0.01), difficulty in emptying (32% vs. 71%, p < 0.01), and incomplete evacuation (32% vs. 66%, p < 0.05) was decreased in patients with sigmoid colectomy. Patient judged as poor bowel function was less frequent in the recent group after low anterior resection (25% vs. 71%, p < 0.01) and sigmoid colectomy (18% vs. 42%, p < 0.05) compared with the previous group. Operative data including volume of blood loss, frequency of transfusion, and length of resected specimen were also different between the two groups. CONCLUSIONS: Surgical technique had a significant impact on bowel function following low anterior resection and sigmoid colectomy for cancer. When high ligation of the inferior mesenteric artery is abandoned and the pelvic autonomic nerve is preserved by careful technique, postoperative bowel dysfunction in patients with rectosigmoid colon cancer can be minimized.

Colectomy↗

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Correlation between tumor size and mode of spread in mass-forming intrahepatic cholangiocarcinoma.

BACKGROUND/AIMS: Mode of spread of intrahepatic cholangiocarcinoma of the mass-forming type (MF-ICC) has not been assessed according to tumor size. METHODOLOGY: We retrospectively evaluated 17 cases of resected MF-ICCs. Tumor size was categorized as follows: < 45 mm (n=4), 45-79 mm (n=7), and > or = 80 mm (n=6). The correlation of tumor size with presence or absence of histological invasion to the portal vein (vp), hepatic vein (vv), intrahepatic metastasis (im), and lymphatic vessel or perineural space (ly/pn) was evaluated. Clinical outcomes of 13 patients who underwent curative resection were also investigated. RESULTS: The positive rates of vp, vv, im, and ly/pn were calculated as 25, 0, 0, and 0% in the < 45-mm group; 86, 29, 86, and 71% in the 45-79-mm group; and 100, 50, 83, and 83% in the > or = 80-mm group, respectively. Of 13 patients who underwent curative resection, 6 of 9 in the > 45-mm group were found to have recurrent diseases in the liver remnant, lymph node, and the lung, whereas one of 4 patients in the < 40-mm group developed peritoneal recurrence. CONCLUSIONS: Systematic hepatectomy without lymphadenectomy might be appropriate for MF-ICC smaller than 45 mm in diameter.

Aged↗

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101 hepatectomies under continuous inflow occlusion following simple in-situ liver cooling in patients with chronic liver diseases.

BACKGROUND/AIMS: Hepatic inflow occlusion involves the serious disadvantage of ischemic injury to the remnant liver, particularly in patients with injured parenchyma. Liver hypothermia is one of the solutions for this problem. The purpose of this study was to evaluate simple in-situ liver cooling method of performing hepatic resection under continuous inflow occlusion in patients with chronic liver disease. METHODOLOGY: One hundred and one patients with chronic hepatitis (n = 26) and cirrhosis (n = 75) were included in this retrospective study. They underwent hepatectomy under conditions of continuous inflow occlusion immediately following simple in-situ liver cooling. Laboratory data and intraoperative and postoperative variables were analyzed for the three groups of patients stratified according to the lowest liver tissue temperature achieved: group 1 (> or = 30 degrees C, n = 16), group 2 (< 30 degrees C and > or = 25 degrees C, n = 62) and group 3 (< 25 degrees C, n = 20). RESULTS: Our simple in-situ liver cooling method enabled us to safely resect chronically diseased liver under continuous inflow occlusion (49.8 +/- 7.7 min, mean +/- SD; range, 30 to 70 min) with acceptable operative blood loss (894 +/- 853mL), morbidity (22.7%, 23/101) and mortality (1.0%, 1/101); one patient died of complications unrelated to ischemic injury. Analysis demonstrated that simple liver hypothermia was substantially hepatoprotective against ischemic injury in terms of serum transaminase levels and duration of inflow occlusion, particularly when the liver tissue temperature fell below 30 degrees C (groups 2 and 3). CONCLUSIONS: Hepatic inflow occlusion can be safely employed in a continuous manner for approximately 1 hour, even during resection of chronically diseased liver, particularly when the liver is cooled below 30 degrees C prior to hepatic clamping by our simple in-situ hypothermia technique.

Aged↗

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Factors influencing recurrence after surgical treatment for T2 gallbladder carcinoma.

BACKGROUND/AIMS: The overall outcome of T2 gallbladder carcinoma has not been favorable, although there is a modest hope for long-term survival after radical resection. The aim of this study was to examine factors influencing postoperative disease-free survival of patients with T2 gallbladder carcinoma to clarify optimal treatment. METHODOLOGY: Of 53 patients with gallbladder carcinoma who had undergone surgical resection from 1985 to 2000, 22 had T2 carcinoma histologically proved. The significance of variables for disease-free survival was examined retrospectively by the Kaplan-Meier method and the log-rank test. RESULTS: There were 16 patients with stage II (T2N0M0), 6 with stage III (T2N1M0) disease. Eleven patients were treated by extended cholecystectomy with resection of the extrahepatic bile duct, 10 patients underwent extended cholecystectomy without resection of the extrahepatic bile duct, and 1 patient underwent cholecystectomy. All patients underwent lymph node dissection in the hepatoduodenal ligament, below the pancreatic head, and along the common hepatic artery. Lymph node metastasis was present in 6 patients. Lymphatic, venous, and perineural invasions were found in 9, 4, and 4 patients, respectively. The absence of lymphatic invasion was a significant factor related to good postoperative disease-free survival (5-year disease-free survival rate, 88.9% vs. 31.3% in the presence of lymphatic invasion). Lymph node, venous, or perineural invasion, and surgical procedure were not significant factors to good postoperative disease-free survival. CONCLUSIONS: For patients with T2 gallbladder carcinoma, the presence of lymphatic invasion is an unfavorable prognostic indicator that calls for additional treatment after radical surgery.

Aged↗

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Microwave coagulation therapy for unresectable hepatocellular carcinoma.

BACKGROUND/AIMS: Surgical resection is not always feasible for patients with hepatocellular carcinoma. We used microwave coagulation therapy (MCT) as an alternative to resection and evaluated its efficacy. METHODOLOGY: Twenty-four patients with unresectable hepatocellular carcinoma underwent microwave coagulation therapy by laparotomy (n=18), laparoscopy (n=4), or thoracoscopy (n=2) because of advanced liver cirrhosis and/or intrahepatic metastases. One nodule was treated in 11 patients, 2 nodules were treated in 7, 3 nodules were treated in 3, 6 nodules were treated in 1, and 7 nodules were treated in 2. Tumor size ranged from 10 to 50 mm. Liver function was analyzed at the time of initial MCT and at treatment for recurrence. Patient outcomes were studied. RESULTS: Two patients died postoperatively after initial MCT. Other patients showed rapid recovery without hepatic dysfunction. Liver function just before MCT was equivalent to that measured just before treatment for recurrence. One patient developed local recurrence at the margin of the treated tumor. Recurrent nodules in different segments were detected in 15 patients. Transcatheter arterial embolization was performed in 13 recurrences, percutaneous ethanol injection therapy was performed in 1 recurrence, and MCT was performed in 1 recurrence. The 3-year cancer-free survival rate was 9.9%, and the 3-year cumulative survival rate was 83.9%. CONCLUSIONS: Because MCT is indicated for hepatocellular carcinoma patients with advanced liver cirrhosis, intrahepatic recurrences are frequent. Since, liver function is preserved after MCT, however, locoregional therapy can be selected when intrahepatic recurrence is detected, thus improving patient survival rate.

Adult↗

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Implications of arterial anatomy in patients with cancer of the periampullary region.

BACKGROUND/AIMS: Preoperative information on arterial anatomy in the peripancreatic and hepatic areas is valuable to any surgeon performing pancreatoduodenectomy. METHODOLOGY: Between 1994 and 1998, 49 patients with periampullary cancer (31 distal bile duct and 18 ampullary tumors) underwent visceral angiography and radical pancreatoduodenectomy with lymphadenectomy. Surgically "significant" arterial variations and their effects on operative management and results were examined retrospectively. RESULTS: Arterial variations were found in 18 patients (37%); 15 (31%) were "significant" and 3 (6%) were "nonsignificant." All 15 patients with "significant" variants required specific type of various preservations of the hepatic arterial system. Intraoperative blood loss, transfused blood units, and operation time were greater in patients with "significant" variations than in patients without (P<0.05). Histopathologic diagnosis, tumor staging, morbidity, and mortality did not differ between the 2 groups. The 5-year survival was 33% for patients with "significant" variations and 63% for patients without (P<0.05). CONCLUSIONS: Information on arterial anatomy in the peripancreatic and hepatic areas is necessary for preoperative evaluation in patients requiring radical pancreatoduodenectomy. Presence of "significant" arterial variations may be considered as one of the negative prognostic factors in patients with periampullary cancer.

Adult↗

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Hepatocellular carcinoma in young adults.

BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) is uncommon in adolescent and young adult Japanese. The aim of this study was to examine the clinicopathological analysis of Japanese young adults with HCC. METHODOLOGY: We reviewed the cases of 11 patients with HCC who were between 13 and 40 years of age. RESULTS: All patients were HBs antigen-positive patients, and most of them had relatively good liver function. Eight patients (72.7%) had abdominal pain directly caused by advanced tumors. Most patients had highly advanced HCC; 9 patients (81.8%) had tumors larger than 10cm in diameter, and all had portal invasion. Nine patients had intrahepatic tumor dissemination. Among 8 patients who underwent hepatectomy 6 survived more than 1 year, and 1 patient has been alive 71 months without disease. The other 3 patients, whose tumors could not be resected, died within 5 months of diagnosis. CONCLUSIONS: These results suggest that cases of HCC in young adults are rarely detected early because of their relatively good liver function despite their higher positive rate for HBs antigen. Therefore, early screening for cancer is particularly important in young adults who are HBs antigen-positive.

Adolescent↗

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Value of serum carbohydrate antigen 19-9 for predicting extrahepatic metastasis in patients with liver metastasis from colorectal carcinoma.

BACKGROUND/AIMS: Serum levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) are frequently elevated in patients with colorectal carcinoma. However, the predictive utility of these two markers has not been fully investigated in patients with liver metastasis. METHODOLOGY: We retrospectively analyzed data obtained from 90 hepatectomy or non-hepatectomy patients with liver metastases from colorectal carcinoma. We examined correlation between serum levels of CEA and CA19-9 and other clinicopathologic factors and performed univariate and multivariate analyses to determine the impact of these tumor markers on extrahepatic metastasis after admission to our hospital. RESULTS: CEA elevation correlated to advanced age (> or = 60 years), and CA19-9 elevation correlated with the site (colon) of primary tumor. Univariate analysis showed that treatment without hepatectomy, > or = 4 hepatic tumors, and CA19-9 elevation had been an adverse effect on extrahepatic disease-free survival time after admission. Multivariate analysis showed that CA19-9 elevation (risk ratio, 1.84) and treatment without hepatectomy (risk ratio, 1.62) had a significant effect on extrahepatic disease-free time. CONCLUSIONS: In patients with colorectal liver metastasis, elevation of serum CA19-9 is a risk factor for extrahepatic metastasis, and CEA appears to be useless for predicting extrahepatic metastasis in these patients.

Adult↗

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Risk factors for early extrahepatic metastasis in patients with liver metastasis from colorectal carcinoma.

BACKGROUND/AIMS: Hepatic resection is one of the most effective therapies for colorectal liver metastasis. However, extrahepatic metastasis is frequently encountered within a short time postoperatively. We attempted to clarify the risk factors for extrahepatic metastasis in patients with colorectal liver metastasis. METHODOLOGY: We retrospectively analyzed data obtained from 116 consecutive patients with colorectal liver metastasis. To determine predictors of extrahepatic metastasis within 1 year of admission for treatment of colorectal liver, we examined 12 clinicopathologic factors by univariate and multivariate logistic regression analyses. RESULTS: Eighty-five underwent hepatectomy and/or thermal ablation (hepatectomy group) and 31 underwent only chemotherapy (non-hepatectomy group). Thirty-one in the hepatectomy group and 19 in the non-hepatectomy group developed extrahepatic metastasis at 1 year after admission. Univariate analysis showed that treatment without hepatectomy and lymphatic vessel permeation at the primary site were significant predictive factors for extrahepatic metastasis within 1 year. Multivariate analysis showed lymphatic permeation of the primary tumor, and treatment without hepatectomy to be significantly related to the occurrence of extrahepatic metastasis within 1 year. CONCLUSIONS: The two factors that we identified put patients with colorectal liver metastasis at high risk for extrahepatic metastasis. Systemic chemotherapy may be needed to prevent extrahepatic disease in such patients.

Age Distribution↗