大腸癌肝転移切除後の残肝再発に対する再肝切除の意義

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  • The Significance of Second Hepatectomy for Recurrent Metastases from Colorectal Primaries.

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The significance of second hepatectomy for recurrent liver metastases from colorectal carcinomawas analyzed in this study. One hundred and seven patients underwent resection of the liver for colorectalcarcinoma metastases between May 1979 and July 1994, ten of whom received a second hepatectomy forrecurrent disease in the residual liver. Although the disease-free interval, size of the tumor, and numberof metastases did not correlate with the prognosis after second hepatectomy, patients with multiplelesions in the bilateral hepatic lobe showed relapse to the remaining liver and died within several monthsof surgery. On the other hand, patients with recurrent lesions in the same hepatic lobe as the metastasesat the first resection survived longer than 4 years without disease. The overall survival rates after secondhepatectomy at 1, 3 and 5 years were 75.0%, 42.8% and 42.8%, and the disease-free survival rates were66.7%, 33.3% and 33.3%, respectively, which were comparable to the result of the first hepatectomy.Therefore, second hepatic resection for liver metastases from colorectal cancer is very beneficial andshould be aggressively performed in selected patients under careful diagnosis.

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