Ann Hepatobiliary Pancreat Surg.  2018 May;22(2):93-100. 10.14701/ahbps.2018.22.2.93.

Clinical significance of post-hepatectomy hepatic failure in patients with liver metastases from colorectal cancer

• Jo HS
• Kim DS
• Jung SW
• Yu YD
• Choi SB
• Kim WB
• Han HJ
• Song TJ

• KMID: 2412423
• DOI: http://doi.org/10.14701/ahbps.2018.22.2.93

Abstract

BACKGROUNDS/AIMS
This study attempted to identify risk factors for development of post-hepatectomy hepatic failure (PHF) and its effect on long-term survival of patients with liver metastases from colorectal cancer.
METHODS
We carried out a retrospective study of 143 patients who had been diagnosed with liver metastases from colorectal cancer and who had undergone hepatectomy between 2003 and 2010. We allocated these patients to PHF and non-PHF groups, using the definition of the International Study Group of Liver Surgery, and compared the clinical factors of the two groups, using Cox regression and Kaplan-Meier analysis to evaluate the differences in overall survival (OS) and recurrence-free survival (RFS) between these groups.
RESULTS
The PHF group comprised 19 patients (13.3%); all had Grade A PHF. Independent risk factors for development of PHF were metachronous liver metastases and major hepatectomy. The differences between the PHF and non-PHF groups in OS or RFS were not statistically significant; however, the PHF group tended to have a worse prognosis. Multivariate analysis revealed significant associations between OS and the factors of poor differentiation of the primary colorectal cancer, major hepatectomy, and positive resection margin.
CONCLUSIONS
Major hepatectomy is an important risk factor for PHF in patients with liver metastases from colorectal cancer. The pathological characteristics of the primary tumor are more important as predictors than is Grade A PHF.

Keyword

Liver metastasis from colorectal cancer; Hepatectomy; International Study Group of Liver Surgery; Hepatic failure

MeSH Terms

Colorectal Neoplasms*
Hepatectomy
Humans
Kaplan-Meier Estimate
Liver Failure*
Liver*
Multivariate Analysis
Neoplasm Metastasis*
Prognosis
Retrospective Studies
Risk Factors

Figure

• 

  Fig. 1 (A) Kaplan-Meier curves showing risk of overall survival by PHF and non-PHF groups. (B) Recurrence-free survival by PHF and non-PHF groups. PHF, post-hepatectomy hepatic failure.

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