Indications for hepatectomy in patients with 4 or more hepatic colorectal metastases remain controversial.
In this study, researchers from Japan examined data from 131 patients who underwent a total of 198 hepatectomies.
|The 5-year survival rate in patients with ≥ 10 nodules was 25%.|
The team grouped the patients according to the number of metastases at the initial hepatectomy (analysis 1). They also grouped patients by the total number of metastases removed by multiple hepatectomies (analysis 2).
In analysis 1, the team calculated the risk of death in patients with 4 to 9 (risk ratio 2.12) and 10 nodules (risk ratio 7.32), compared to those with 1 to 3 nodules.
Using analysis 2, they found that the risk ratios for death were 1.32 in patients with 4 to 9 nodules, and 3.07 in patients with 10 nodules.
In analysis 2, the 5-year survival rates of patients with 1 to 3, 4 to 9, and 10 or more nodules were 51%, 46%, and 25%, respectively.
Dr Hiroshi Imamura's team concluded, "Hepatic resection for patients with 4 to 9 nodules clearly is warranted".
"On the other hand, for patients with 10 or more tumor nodules, surgery cannot be ensured absolutely to be contraindicated in high volume centers at which the surgical mortality rate is nearly zero".