PMID: 9529015Apr 7, 1998Paper

Intraoperative determinants of unresectability for patients with colorectal hepatic metastases

Cancer
J F GibbsN J Petrelli

Abstract

Intrahepatic and extrahepatic factors are utilized by the surgeon in the decision-making process for the performance of hepatic resection for patients with colorectal metastases. Accurate preoperative and intraoperative staging are mandatory to avoid unnecessary surgery. In this report the intraoperative determinants of hepatic unresectability were evaluated. This was a retrospective review of medical records from January 1985 to March 1996 of 62 patients with colorectal hepatic metastases who at the time of exploratory laparotomy were deemed to have unresectable disease based on intrahepatic or extrahepatic factors. The stage of the primary tumor, disease free interval, preoperative carcinoembryonic antigen, computed tomography portography, intraoperative ultrasound, and assessment of intrahepatic and extrahepatic tumor extension were evaluated. Intraoperative determination of the extent of required hepatic resection, including trisegmentectomy (9 patients; 15%) and total hepatectomy (10 patients; 16%), accounted for the majority of unresectable patients. Patients with > 4 metastases (8 patients; 13%) and satellitosis (6 patients; 10%) accounted for 23% of unresectable patients. Four patients had extensive nonmalignant hepatic...Continue Reading

References

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Citations

Jul 22, 2006·Annals of Surgery·Stephen R GrobmyerWilliam R Jarnagin
Mar 1, 2006·Seminars in Interventional Radiology·J Alexander PalestyJohn F Gibbs
May 8, 2001·Cancer Investigation·M S KahlenbergN J Petrelli
Sep 24, 2005·Journal of Surgical Oncology·Joseph J BennettMitchell C Posner
Jun 15, 2004·Journal of the American College of Surgeons·Christophe LaurentJean Saric
Mar 31, 2004·Journal of the American College of Surgeons·George N TzimasSarkis Meterissian
May 9, 2003·Surgical Oncology Clinics of North America·Dominique M Elias, Jean-François Ouellet
Apr 6, 2004·The Surgical Clinics of North America·John F GibbsMorton S Kahlenberg
Apr 6, 2004·The Surgical Clinics of North America·Vijay P Khatri, John McGahan
Sep 6, 2000·The British Journal of Surgery·M S Rodgers, J L McCall
Jan 12, 2002·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·T J M RuersW J G Oyen
Sep 29, 2011·Arquivos De Gastroenterologia·Eduardo Freitas VianaIvan Cecconello
Jul 24, 2004·Expert Review of Anticancer Therapy·Bastiaan WieringWim J G Oyen
May 10, 2002·The Cancer Journal·Richard EssnerArmando E Giuliano
Sep 22, 2010·Nuclear Medicine Communications·Bastiaan WieringWim J G Oyen
Jun 16, 2009·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Theo J M RuersWim J G Oyen

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