Right and Left Colorectal Cancer: Differences in Post-Surgical-Care Outcomes and Survival in Elderly Patients

(1) There is evidence of the embryological, anatomical, histological, genetic and immunological differences between right colon cancer (RCC) and left colon cancer (LCC). This research has the general objective of studying the differences in outcome between RCC and LCC. (2) A longitudinal analytical study with prospective follow-up of the case–control type was conducted from 1 January 2010 to 31 December 2017 including 398 patients with 1:1 matching, depending on the location of the tumor. Inclusion criteria: programmed colectomies, 15 cm above the anal margin, adults and R0 surgery. (3) Precisely 6.8% of the exitus occurred in the first 6 months of the intervention. At 6 months, patients with LCC presented a mean survival of 7 months higher than RCC (p = 0.028). In the first stages, it can be observed that most of the exitus are for patients with RCC (stage I p = 0.021, stage II p = 0.014). In the last stages, the distribution of the deaths does not show differences between locations (stage III p = 0.683, stage IV p = 0.898). (4) The results show that RCC and LCC are significantly different in terms of evolution, progression, complications and survival. Patients with RCC have a worse prognosis, even in the early stages of the disease, due to more advanced N stages, larger tumor size, more frequently poorly differentiated tumors and a greater positivity of lymphovascular invasion than LCC.

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A Comparison of Treatments and Outcomes for Medullary versus Nonmedullary Colon Cancer: A Single Institutional Experience Showing a Worse Prognosis for Stage 3 Disease

Surgery Research and Practice ◽

10.1155/2020/5783729 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

A. Gupta ◽

B. Protyniak ◽

J. Dove ◽

K. Chu ◽

T. Erchinger ◽

...

Keyword(s):

Colon Cancer ◽

Median Survival ◽

Contributing Factors ◽

Kaplan Meier ◽

Chi Squared ◽

Institutional Experience ◽

Comorbidity Index ◽

Poorly Differentiated ◽

Similar Survival ◽

Worse Prognosis

Background. Prior studies have shown a better prognosis with medullary colon cancer (MCC) compared to nonmedullary colon carcinomas (NMC); however, data are inconsistent and lacking the evaluation of treatments received. As we did not see similar survival outcomes, we aimed to retrospectively examine survival and receipt of treatment differences between MCC and NMC within the Geisinger Health System. Methods. The Cancer Registry was retrospectively reviewed for MCC and NMC from 2006 to 2017. Demographics and treatments were compared using T-test and chi-squared analyses, also comparing MCC to poorly differentiated (PD) or undifferentiated (UD) NMC. Overall survival was analyzed using Kaplan–Meier curves and log-rank tests. Results. 33 MCC and 1775 NMC patients were identified and 31 (93.9%) MCC and 1433 (87.0%) NMC underwent resection. MCC were older (p=0.0002), had a higher Charlson Comorbidity Index (p=0.013) and were more likely right sided (p=0.013). Seven patients (22.6%) with MCC vs. 149 (10.4%) NMC underwent resection of contiguous organs. Overall median survival was significantly worse for MCC as compared to NMC (19.6 vs. 60.5 months, p=0.0002). Only stage 3 patients had a significantly worse median survival when compared to PD/UD NMC (9.6 vs. 47.2 months, p<0.001). Contiguous organ resection and failure to receive chemotherapy were not found as contributing factors to decreased survival. Conclusion. Multiple previous studies showed a better prognosis for MCC compared to PD/UD NMC. We, however, found stage 3 patients had a worse prognosis which may be secondary to higher comorbidities, increased stage, and higher rate of UD.

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Analysis of survival and prognostic factors in metastatic colorectal cancer patients treated with first line bevacizumab.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e15009 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e15009-e15009 ◽

Cited By ~ 1

Author(s):

Nazim Demircan ◽

Faysal Dane ◽

Mehmet Akif Ozturk ◽

Mehmet Besiroglu ◽

Nalan Babacan ◽

...

Keyword(s):

Colorectal Cancer ◽

Colon Cancer ◽

Prognostic Factors ◽

Metastatic Colorectal Cancer ◽

Cancer Patients ◽

First Line ◽

Right Colon Cancer ◽

Kras Status ◽

Colorectal Cancer Patients ◽

Left Colon Cancer

e15009 Background: Colorectal cancer is a major cause of mortality worldwide. Survival has been improved by usage of bevacizumab. Our study aimed to analyze survival and prognostic factors in metastatic colorectal cancer patients treated with first-line bevacizumab. Methods: Files of patients were examined retrospectively and 360 patients treated with first-line bevacizumab were included. Data regarding age, gender, family history, location of the primary, histopathology, KRAS status, surgery and chemotherapy were acquired from the files. Overall response rates (ORR) to chemotherapy, progression and exitus dates or dates of last examination were recorded. Median progression-free and overall survival (PFS and OS) were calculated. Survival was analyzed with Kaplan-Meier method. Log-rank test and Cox regression model were used for univariate and multivariate analysis, respectively. Results: 201 (%55,8) of the patients were male and 159 (%44,2) were female. Median age at the time of the diagnosis was 59.5. 260 patients (%72,2) had initially stage IV disease. KRAS was mutant in 125 patients (%34,7). Median PFS was 8.5 months, median OS was 25.3 months and ORR was %51,4. Median PFS was 8.2 and 9.5 months, median OS was 30.4 and 28.1 months, ORR was %62,6 and %58.4 in KRAS wild type and mutant groups, respectively. In patients with left colon cancer median PFS and OS (9.6 and 27.1 months) were superior compared to patients with right colon cancer (7.3 and 19.4 months) (p = 0.005 and 0.016, respectively). Location of the primary, histopathologic grade, primary surgery, metastasectomy and KRAS status affected overall survival significantly (p < 0.05) in univariate analysis. In multivariate analysis, histopathologic grade (p = 0.034) and metastasectomy (p = 0.001) were independent prognostic factors. Conclusions: In our study, response rates and survival of metastatic colorectal cancer patients treated with first-line bevacizumab were similar to previous studies. Left colon cancer patients had superior median PFS and OS compared to right colon cancer patients as shown in recent studies. Histopathologic grade and metastasectomy were independent prognostic factors in correlation with literature.

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Effect of tumor progression on colon cancer stem cell plasticity.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.4_suppl.688 ◽

2018 ◽

Vol 36 (4_suppl) ◽

pp. 688-688

Author(s):

Vi Kien Chiu ◽

Rama Gallupalli ◽

Diaa Osman ◽

Zhaoshi Zeng ◽

Jinru Shia ◽

...

Keyword(s):

Colon Cancer ◽

Stem Cell ◽

Stage Iv ◽

Human Colon ◽

Stage I ◽

Normal Colon ◽

Colon Adenoma ◽

Colon Cancer Stem Cell ◽

Tumor Plasticity ◽

Poorly Differentiated

688 Background: Stage I colon cancer initiation is optimized through the activation of the embryonic stem cell (SC)-like program in colon adenoma cells (Le Rolle AF, et al., 2016). This malignant transformation requires cellular dedifferentiation since the embryonic SC-like program does not exist a priori in colon cells. High initial tumor plasticity provides a competitive advantage as the tumor has more intrinsic phenotypic flexibility to survive environmental challenges. Inhibition of the embryonic SC-like program represents a novel therapeutic strategy. Herein, we examine the evolution this high tumor plasticity in stage I-IV colon cancer. Methods: Human colon cancer tissues were collected prospectively under an MSKCC IRB protocol (Jan 1990-Dec 2000). RNA in situ hybridization of LGR5, a colon SC marker, was carried out on human colon tumors before and after therapeutic interventions. We performed Gene Set Enrichment Analysis (GSEA 2.0 Broad Institute software) using Affymetrix U133A expression profiles from normal colon mucosa (n = 33) and colon cancer epithelia from stage I (n = 17), II (n = 35), III (n= 39) and IV (n= 46) tumors. Statistical analyses were conducted with GraphPad Prism 5 and Microsoft Excel. Results: Putative colon SC markers and differentiation markers are increased and decreased, respectively, in stage I-IV colon cancer in comparison to normal colon. Although colon adenoma originates from LGR5+ colon SC, LGR5+ overexpression per se correlates with good prognosis stage IV colon cancer and is not a colon cancer stem cell biomarker. Maximal embryonic SC-like program enrichment occurs in stage I colon cancer. GSEA comparisons of moderately differentiated stages II-IV versus stage I colon cancer reveal progressive tumor differentiation from the stage I embryonic SC-like program toward the intestinal SC program at more advanced tumor stages. Notably, poorly differentiated stage IV colon cancer retains an embryonic SC-like program. Conclusions: We conclude that except for poorly differentiated tumors, colon cancer progression from stage I to IV involves a heterogeneous tumor differentiation process from an embryonic SC-like program towards the intestinal SC or more differentiated intestinal cell programs.

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Predictive Value of Body Composition Analysis for the Prognosis of Patients with Advanced Gastrointestinal Tumors

journal of nutritional oncology ◽

10.34175/jno202004005 ◽

2020 ◽

Vol 5 (4) ◽

pp. 182-188

Author(s):

Hai Mei Yang ◽

◽

Yi Zhuo Wang ◽

Xiang Liang Liu ◽

Wei Ji ◽

...

Keyword(s):

Gastric Cancer ◽

Skeletal Muscle ◽

Colon Cancer ◽

Body Composition ◽

Left Colon ◽

First Line ◽

Right Colon ◽

Right Colon Cancer ◽

Left Colon Cancer

Objective There is strong evidence that the body composition can affect the progression-free survival (PFS) and overall survival (OS) in patients with a variety of cancers. The main objective of this study was to investigate the effect of body composition on the prognosis of patients with advanced gastrointestinal and colorectal cancers who received first-line palliative chemotherapy. Methods Patients who were newly-diagnosed with advanced gastrointestinal or colorectal cancer and received standard first-line palliative chemotherapy from January 2017 to December 2018 were included in this retrospective study. An analysis of computed tomography images was performed to determine the skeletal muscle index (SMI), which reflects the skeletal muscle mass and skeletal muscle density (SMD) related to muscle strength. A Kaplan-Meier survival analysis and log-rank test were used to compare the survival relationships among groups stratified by the SMI, and a Cox proportional hazard model was used for a multivariate analysis. Results A total of 108 patients met the inclusion criteria, including 41 cases of gastric cancer, 46 cases of left colorectal cancer, and 21 cases of right colon cancer. In patients with gastric cancer, the OS of women was significantly shorter than that of men. The OS of patients with a low SMI, low SMD, and low phase angle (PA) was significantly shorter than that of patients with high values (P ≤ 0.05). In the multivariate analysis, the SMD was significantly associated with the patients' long-term survival [Hazard Ratio (HR) = 0.904, 95% CI: 0.840~0.974, P = 0.008]. For patients with a low SMI and PA, the PFS was significantly shorter than that of patients with high values (P ≤ 0.05). In patients with left colon cancer, the PA and SMD were both independent risk factors for a poorer long-term prognosis (HR = 0.375, 95% CI: = 0.167~0.840, P = 0.017; HR = 0.887, 95% CI: 0.824~0.954, P = 0.001). Among right colon cancer patients, the PFS and OS of those with a low SMD were significantly lower than those for patients with high values (P ≤ 0.05). Conclusion The PA is an independent risk factor for the OS of left colon cancer patients; the SMD is an independent risk factor for the survival of patients with gastric cancer, left colon cancer, and right colon cancer.

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Updated results of a phase II trial integrating gefitinib (G) into concurrent chemoradiation (CRT) followed by G adjuvant therapy for locally advanced head and neck cancer (HNC)

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.6028 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 6028-6028 ◽

Cited By ~ 7

Author(s):

S. M. Ahmed ◽

E. E. Cohen ◽

D. J. Haraf ◽

K. M. Stenson ◽

E. Blair ◽

...

Keyword(s):

Adjuvant Therapy ◽

Locally Advanced ◽

Stage Iv ◽

Early Death ◽

Complete Response ◽

Poorly Differentiated ◽

Patient Refusal ◽

Grade 3 ◽

Ecog Ps

6028 Background: This study was undertaken to evaluate the tolerability and efficacy of substituting G for paclitaxel into a well- described CRT regimen (Clin Cancer Res 9: 5936; JCO 21: 320) and continuing G as adjuvant therapy. Endpoints included complete response (CR) rate to CRT, progression-free (PFS), disease-specific (DSS) and overall survival (OS), and local & distant control rates. Methods: Previously untreated subjects with stage III, IVa, or IVb squamous cell, poorly differentiated carcinomas, or lymphoepithelioma were enrolled. Organ sparing surgery was allowed. Subjects received 2 cycles of carboplatin/paclitaxel induction followed by CRT with G (250 mg PO qd), 5- fluorouracil, hydroxyurea, and twice daily radiation on day 1–5 of five 14d cycles. G was continued for 2 years from the start of CRT. Results: From 2/03 to 10/04, 67 eligible subjects accrued including 51 males; median age 56; ECOG PS 0 in 47, 1 in 19, and 2 in 1; stage IV in 61 (91%). With median follow-up of 858 days, 9 have had progressive disease (PD, 3 distant, 5 local, 1 with both) and 15 have died (12 related to HNC). Estimated OS=83% at 2y, 73% at 3y; PFS=77% at 2y, 64% at 3y; and DSS=86% at 2y, 80% at 3y. In 56 evaluable subjects we observed 51 CR (91 %), 4 partial responses and 1 PD after CRT. Non-evaluable subjects underwent surgery prior to CRT (10), or died prior to evaluation (1). Grade 3/4 toxicity included mucositis (75%/10%), dermatitis (29%/3%), rash (4%/0%) and diarrhea (1%/0%). Sixty-two patients received maintenance gefitinib, with 60 reliably reporting doses (median days on gefitinib=667). Reasons for holding G included LFT abnormalities, patient refusal, diarrhea, rash, recurrence, hospitalization for acute illness, and early death. Conclusions: Adding G to concurrent CRT after induction therapy, and as adjuvant therapy is tolerable and feasible. Favorable survival and CR data suggest that this is a promising regimen for patients with locally advanced HNC. [Table: see text]

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Efficacy of Adjuvant Fluorouracil and Folinic Acid in B2 Colon Cancer

Journal of Clinical Oncology ◽

10.1200/jco.1999.17.5.1356 ◽

1999 ◽

Vol 17 (5) ◽

pp. 1356-1356 ◽

Cited By ~ 391

Keyword(s):

Colon Cancer ◽

Confidence Interval ◽

Folinic Acid ◽

Cox Model ◽

Pooled Analysis ◽

Treatment Control ◽

Data Set ◽

Poorly Differentiated ◽

Small Benefit

PURPOSE: The goal of this analysis was to determine whether fluorouracil (FU) and folinic acid (leucovorin, LV) is an effective adjuvant therapy for patients after potentially curative resection of colon cancer in patients with B2 tumors. PATIENTS AND METHODS: One thousand sixteen patients with B2 colon cancer entered onto five separate trials were randomized to FU + LV or observation. A pooled analysis for event-free (EFS) and overall survival (OS) using a stratified log-rank and Cox model was performed. RESULTS: The median follow-up duration was 5.75 years. Patients receiving FU + LV did not experience a significant increase in EFS or OS. The hazards ratio at 5 years was 0.83 (90% confidence interval, 0.72 to 1.07) for EFS and 0.86 (90% confidence interval, 0.68 to 1.07) for OS. The 5-year EFS was 73% for controls and 76% for FU + LV. The 5-year OS was 80% for controls and 82% for FU + LV. Increasing age and poorly differentiated tumors were significant indicators of poor prognosis (P < .02). CONCLUSION: This data set does not support the routine use of FU + LV in all patients with B2 colon cancer. Longer follow-up may identify a small benefit. At present, studies in B2 colon cancer designed with a no-treatment control arm should be considered appropriate.

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IS THERE A DIFFERENCE BETWEEN RIGHT- VERSUS LEFT-SIDED COLON CANCERS? DOES SIDE MAKE ANY DIFFERENCE IN LONG-TERM FOLLOW-UP?

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/0102-672020190001e1479 ◽

2019 ◽

Vol 32 (4) ◽

Cited By ~ 1

Author(s):

Leonardo Alfonso BUSTAMANTE-LOPEZ ◽

Sergio Carlos NAHAS ◽

Caio Sergio R. NAHAS ◽

Rodrigo Ambar PINTO ◽

Carlos Frederico S. MARQUES ◽

...

Keyword(s):

Colon Cancer ◽

Survival Time ◽

Right Colon ◽

Risk Of Death ◽

Colon Cancers ◽

Right Colon Cancer ◽

Long Term Follow Up ◽

Disease Entities ◽

Left Colon Cancer

ABSTRACT Background: Since 1990 it was proposed that distal and proximal location of colon cancer might follow different biological, epidemiology, pathology and prognosis, probably due to embryologic different development of the two segments of the colon, which may represent two separate disease entities. These differences might have consequences for the treatment of patients with colorectal cancer. Aim: To compare the characteristics between patients with right and left colon cancer, with severity and tumor characteristic that influence in the survival of these patients. Method: Were evaluated the outcomes of surgical treatment of patients with colon cancer with data collected retrospectively from prospectively collected database. Results: The tumor’s side did not influence survival time of patients with colon cancer (p=0.112) in the regression model. Only the diseases stage leads to influence on survival time; patients with right colon cancer have more advanced staging (III or IV) and present a risk of death greater in 3.23 times. Conclusion: This analysis provides evidence that the prognosis of localized left-sided colon cancer is better compared to right-sided colon cancer. Also, the patients with right colon cancer have more advanced stage, mucinous tumor and are older.

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Systematic review of comparing single-incision versus conventional laparoscopic right hemicolectomy for right colon cancer

World Journal of Surgical Oncology ◽

10.1186/s12957-019-1721-6 ◽

2019 ◽

Vol 17 (1) ◽

Cited By ~ 2

Author(s):

Xin Liu ◽

Wei-hong Yang ◽

Zhou-guang Jiao ◽

Ji-fu Zhang ◽

Rui Zhang

Keyword(s):

Colon Cancer ◽

Meta Analysis ◽

Right Hemicolectomy ◽

Right Colon ◽

Chi Square ◽

Right Colon Cancer ◽

Laparoscopic Right Hemicolectomy ◽

Operation Duration ◽

The Right

Abstract Background Single-incision laparoscopic right hemicolectomy (SILS) has long used in surgery for a long time. However, there is barely a systemic review related to the comparison between the SILS and the conventional laparoscopic right hemicolectomy (CLS) for the right colon cancer in the long term follow-up. Herein, we used the most recent articles to compare these two techniques by meta-analysis. Methods We searched PubMed, Web of Science, Cochrane Library and Wanfang databases to compare SILS with CLS for right colon cancer up to May 2019. The operative, postoperative, pathological and mid-term follow-up outcomes of nine studies were extracted and compared. Results A total of 1356 patients participated in 9 studies, while 653 patients were assigned to the SILS group and 703 patients were assigned to the CLS group. The patients’ baselines in the SILS group were consistent with those in the CLS group. Compared to the CLS group, the SILS group had a shorter operation duration (SMD − 23.49, 95%CI − 36.71 to − 10.27, P < 0.001, chi-square = 24.11), shorter hospital stay (SMD − 0.76, 95% `CI − 1.07 to − 0.45, P < 0.001, chi-square = 9.85), less blood loss (SMD − 8.46, 95% CI − 14.59 to − 2.34; P < 0.05; chi-square = 2.26), smaller incision length (SMD − 1.60, 95% CI − 2.66 to − 0.55, P < 0.001; chi-square = 280.44), more lymph node harvested (SMD − 0.98, 95% CI − 1.79 to − 0.16, P < 0.05; chi-square = 4.61), and a longer proximal surgical edge (SMD − 0.51, 95% CI − 0.93 to − 0.09, P < 0.05; chi-square = 2.42). No significant difference was found in other indexes. After we removed a single large study, we performed another meta-analysis again. The operation duration in the SILS group was still better than that in the CLS group. Conclusion SILS could be a faster and more reliable approach than CLS for the right colon cancer and could accelerate patient recovery, especially for patients with a low BMI.

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Survival by colon cancer stage and screening interval in Lynch syndrome: a prospective Lynch syndrome database report

Hereditary Cancer in Clinical Practice ◽

10.1186/s13053-019-0127-3 ◽

2019 ◽

Vol 17 (1) ◽

Cited By ~ 9

Author(s):

Mev Dominguez-Valentin ◽

Toni T. Seppälä ◽

Julian R. Sampson ◽

Finlay Macrae ◽

Ingrid Winship ◽

...

Keyword(s):

Colorectal Cancer ◽

Colon Cancer ◽

Lynch Syndrome ◽

Stage Iv ◽

Cancer Stage ◽

Pathological Stage ◽

Screening Interval ◽

Advanced Colon Cancer ◽

Variant Database

Abstract Background We previously reported that in pathogenic mismatch repair (path_MMR) variant carriers, the incidence of colorectal cancer (CRC) was not reduced when colonoscopy was undertaken more frequently than once every 3 years, and that CRC stage and interval since last colonoscopy were not correlated. Methods The Prospective Lynch Syndrome Database (PLSD) that records outcomes of surveillance was examined to determine survival after colon cancer in relation to the time since previous colonoscopy and pathological stage. Only path_MMR variants scored by the InSiGHT variant database as class 4 or 5 (clinically actionable) were included in the analysis. Results Ninety-nine path_MMR carriers had no cancer prior to or at first colonoscopy, but subsequently developed colon cancer. Among these, 96 were 65 years of age or younger at diagnosis, and included 77 path_MLH1, 17 path_MSH2, and 2 path_MSH6 carriers. The number of cancers detected within < 1.5, 1.5–2.5, 2.5–3.5 and at > 3.5 years after previous colonoscopy were 9, 43, 31 and 13, respectively. Of these, 2, 8, 4 and 3 were stage III, respectively, and only one stage IV (interval 2.5–3.5 years) disease. Ten-year crude survival after colon cancer were 93, 94 and 82% for stage I, II and III disease, respectively (p < 0.001). Ten-year crude survival when the last colonoscopy had been < 1.5, 1.5–2.5, 2.5–3.5 or > 3.5 years before diagnosis, was 89, 90, 90 and 92%, respectively (p = 0.91). Conclusions In path_MLH1 and path_MSH2 carriers, more advanced colon cancer stage was associated with poorer survival, whereas time since previous colonoscopy was not. Although the numbers are limited, together with our previously reported findings, these results may be in conflict with the view that follow-up of path_MMR variant carriers with colonoscopy intervals of less than 3 years provides significant benefit.

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Results of surgical treatment of colorectal cancer liver metastases in Latvia oncology center.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.485 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 485-485

Author(s):

Armands Sivins ◽

Lelde Lauka ◽

Guntis Ancans ◽

Sergejs Gerkis ◽

Andrejs Pcolkins ◽

...

Keyword(s):

Colorectal Cancer ◽

Colon Cancer ◽

Postoperative Complications ◽

Liver Metastases ◽

Primary Tumor ◽

Stage Iv ◽

Colorectal Cancer Liver Metastases ◽

Left Colon Cancer ◽

Major Hepatectomies ◽

Oncology Center

485 Background: Colorectal cancer (CRC) is the third leading cause of cancer death. At the time of diagnosis 25% of patients present with stage IV disease and out of all CRC patients 50% develop liver metastases. About 15% of them have initially resectable disease. Surgical resection is the best treatment option as it is associated with longer survival. Latvia Oncology center (LOC) provide expertise in managment of all cancers, including metastatic CRC. Methods: Data about CRC patients with surgicaly treated liver metastases was colected and analysed from Latvia Oncology center in period 2011-2014. This data is also included in LiverMetSurvey international registry of patients operated for CRC liver metastases. 66 patients underwent hepatectomies, 10 patients had 2 or more surgeries due to a reccurent disease. Results: 77 surgeries were performed, 31 were hemihepatectomies and 46 were limited resections. Sinchronous surgery for liver metastases and primary tumor were performed in 19 cases: 11 for left colon cancer, 6 for rigt colon cancer and 2 for rectal cancer. Initially resectable liver disease was found in 70 cases. Unilateral metastases were diagnosed in 61 cases while there were 17 cases of bilateral disease. Postoperative complications developed in 18 patients, 5 of those after sinchronous surgeries for primary tumor. In 10 cases complications developed after major anatomical right sided hemihepatectomy and in 8 cases after atypical resections. Most frequent hepatic complications were infected collection in hepatic loge (n=9), non infected collection (n=3) and biliary leak (n=3); all of those were successfully treated with percutaneous dreinage. 1 patient died due to a postoperative liver insufficiency after right sided hemihepatectomy for recurrent disease. Conclusions: Overall 77 hepatectomies were performed, mostly limited non anatomical resections. In majority of patients 1 or 2 metastases were diagnosed. Initally resectable were 89% of cases. Mass of postoperative complications developed after major hepatectomies, were liver related and successfully treated with minimally invasive procedures. Complication rate (16%) in LOC is comperable to other Europian centers.

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