| 特集名 | 大腸癌肝転移の画像診断と治療 | |
|---|---|---|
| 題名 | 治療 (2) 肝切除 a. 系統的切除 | |
| 発刊年月 | 2003年 05月 | |
| 著者 | 安井 健三 | 愛知県がんセンター消化器外科 |
| 著者 | 清水 泰博 | 愛知県がんセンター消化器外科 |
| 著者 | 金光 幸秀 | 愛知県がんセンター消化器外科 |
| 著者 | 平井 孝 | 愛知県がんセンター消化器外科 |
| 著者 | 加藤 知行 | 愛知県がんセンター消化器外科 |
| 【 要旨 】 | 要旨はありません。 | |
| Theme | Recent advances in the diagnostic imaging and the treatment of liver metastates from colorectal cancer | |
|---|---|---|
| Title | A significance of anatomical hepatectomy for colorectal liver metastases | |
| Author | Kenzo Yasui | Department of Gastroenterological Surgery, Aichi Cancer Center |
| Author | Yasuhiro Shimizu | Department of Gastroenterological Surgery, Aichi Cancer Center |
| Author | Yukihide Kanemitsu | Department of Gastroenterological Surgery, Aichi Cancer Center |
| Author | Takashi Hirai | Department of Gastroenterological Surgery, Aichi Cancer Center |
| Author | Tomoyuki Kato | Department of Gastroenterological Surgery, Aichi Cancer Center |
| [ Summary ] | To evaluate the significance of anatomical hepatectomy for liver metastases, we investigated 129 radically hepatectomized patients with colorectal liver metastases. Of the 129, 106 patients underwent anatomical hepatectomy with lymph node dissection. Macroscopic local invasive factors (IF) were found in 49 out of 106 anatomically hepatectomized patients (46.2%) The cumulative five-year survival rate in the IF-negative group was (50.8%), significantly better than those in the IF-positive group (29.4%) (p=0.0157). Two of the eleven patients with hepatic lymph node metastases survived over five years. One of them has survived without any recurrence for over twelve years since the hepatectomy. According to the Yasui's classification, the five-year survival rate in the Simple Nodular group (52.2%) was significantly better than in the Confluent Nodular group (31.6%) (p=0.0218). Tumor recurrence was found in 71 (67%) of the 106 anatomically hepatectomized patients. Of these, recurrence in the remnant liver was found in 21 cases (19.8%). On the other hand, 9 (39.1%) out of the 23 partially hepatectomized patients had remnant liver recurrence. It is considered that anatomical hepatectomy could provide a better local control and prognostic results than partial hepatectomy when the liver metastasis displays the same clinicopathologic condition. |
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