The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.
Long-Term Results of Two-Stage Hepatectomy for Irresectable Colorectal Cancer Liver Metastases
Abstract
OBJECTIVE: To assess feasibility, risks, and long-term outcome of 2-stage hepatectomy as a means to improve resectability of colorectal liver metastases (CLM). SUMMARY BACKGROUND DATA: Two-stage hepatectomy uses compensatory liver regeneration after a first noncurative hepatectomy to enable a second curative resection. METHODS: Between October 1992 and January 2007, among 262 patients with initially irresectable CLM, 59 patients (23%) were planned for 2-stage hepatectomy. Patients were eligible when single resection could not achieve complete treatment, even in combination with chemotherapy, portal embolization, or radiofrequency, but tumors could be totally removed by 2 sequential resections. Feasibility and outcomes were prospectively evaluated. RESULTS: Two-stage hepatectomy was feasible in 41 of 59 patients (69%). Eighteen patients failed to complete the second hepatectomy because of disease progression (n = 17) or bad performance status (n = 1). The 41 successfully treated patients had a mean number of 9.1 metastases (mean diameter, 48.5 mm at diagnosis). Chemotherapy was delivered before (95%), in between (78%), and after (78%) the 2 hepatectomies. Mean delay between the 2 liver resections was 4.2 months. Postoperative mortality was 0% and 7% (3/41) after the first and second hepatectomy, respectively. Morbidity rates were also higher after the second procedure (59% vs. 20%) (P < 0.001). Five-year survival was 31% on an intention to treat basis, and all but 2 patients who did not complete the 2-stage strategy died within 19 months. After a median follow-up of 24.4 months (range, 3.7-130.3), overall 3- and 5-year survivals for patients that completed both hepatectomies were 60% and 42%, respectively, after the first hepatectomy (median survival, 42 months from first hepatectomy and 57 months from metastases diagnosis). Disease-free survivals were 26% and 13% at 3 and 5 years, respectively. CONCLUSIONS: Two-stage hepatectomy provides a 5-year survival of 42% and a hope of long-term survival for selected patients with extensive bilobar CLM, irresectable by any other means.
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Self-citationSolbiati, L., Livraghi, T., Goldberg, S. N., Ierace, T., Meloni, F., Dellanoce, M., Cova, L., Halpern, E. F., & Gazelle, G. S. (2001) · Radiology · doi:10.1148/radiol.2211001624 · Cited by 870
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Hepatic metastases from colorectal carcinoma: Impact of surgical resection on the natural history
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Two-Stage Hepatectomy: A Planned Strategy to Treat Irresectable Liver Tumors
Adam, R., Laurent, A., Azoulay, D., Castaing, D., & Bismuth, H. (2000) · Annals of Surgery · doi:10.1097/00000658-200012000-00006 · Cited by 801
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Cited by
The Clavien-Dindo Classification of Surgical Complications: Five-Year Experience
Clavien, P. A., Barkun, J., de Oliveira, M. L., Vauthey, J. N., Dindo, D., Schulick, R. D., de Santibañes, E., Pekolj, J., Slankamenac, K., Bassi, C., et al. (2009) · Annals of Surgery · doi:10.1097/sla.0b013e3181b13ca2 · Cited by 11,482
Folprecht, G., Gruenberger, T., Bechstein, W. O., Raab, H.-R., Lordick, F., Hartmann, J. T., Lang, H., Frilling, A., Stoehlmacher, J., Weitz, J., et al. (2010) · The Lancet Oncology · doi:10.1016/s1470-2045(09)70330-4 · Cited by 963
Taylor, A., Primrose, Langeberg, W., Kelsh, Mowat, F., Alexander, D., Choti, M., Poston, G., & Kanas, G. (2012) · Clinical Epidemiology · doi:10.2147/clep.s34285 · Cited by 657
Brouquet, A., Abdalla, E. K., Kopetz, S., Garrett, C. R., Overman, M. J., Eng, C., Andreou, A., Loyer, E. M., Madoff, D. C., Curley, S. A., et al. (2011) · Journal of Clinical Oncology · doi:10.1200/jco.2010.32.6132 · Cited by 396
Role of surgery in colorectal cancer liver metastases
Akgül, Ö. (2014) · World Journal of Gastroenterology · doi:10.3748/wjg.v20.i20.6113 · Cited by 259
Metadata
- Authors
- Wicherts, D. A., Miller, R., de Haas, R. J., Bitsakou, G., Vibert, E., Veilhan, L.-A., Azoulay, D., Bismuth, H., Castaing, D., & Adam, R.
- Venue
- Annals of Surgery
- Published
- 2008-12
- Volume
- 248
- Issue
- 6
- Pages
- 994-1005
- ISSN
- 0003-4932 (ISSN-L)
- OpenAlex
- W2072925972
- Cited by
- 332
- References
- 32
- FWCI
- 9.09
- Type
- journal article
- Language
- en
- Open access
- closed
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- CoChat. (2026). Citation check: Long-Term Results of Two-Stage Hepatectomy for Irresectable Colorectal Cancer Liver Metastases. https://app.cochat.ai/papers/10.1097/sla.0b013e3181907fd9
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- Wicherts, D. A., Miller, R., de Haas, R. J., Bitsakou, G., Vibert, E., Veilhan, L.-A., Azoulay, D., Bismuth, H., Castaing, D., & Adam, R. (2008). Long-Term Results of Two-Stage Hepatectomy for Irresectable Colorectal Cancer Liver Metastases. Annals of Surgery. https://doi.org/10.1097/sla.0b013e3181907fd9
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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