Chirurgie der Leber: Grenzen des Machbaren

Zusammenfassung

Einleitung: Bilobäre Lebermetastasen, ein geringes Restlebervolumen, De-novo- und Rezidivmetastasen, simultane Lungenmetastasen und die Infiltration von Gefäßen sind häufig limitierende Faktoren in der chirurgischen Therapie primärer und sekundärer Lebertumoren. Dennoch ist die Chirurgie der „Gold Standard” mit der Möglichkeit von einem Langzeitüberleben, an das lokalablative Maßnahmen und Chemotherapie nicht herankommen. Methoden: Die Kombination mit neoadjuvanter Chemotherapie und lokalablativen Verfahren, erweiterte Leberresektionen nach selektiver Pfortaderembolisation, zweizeitige Resektionen, die Resektion und Rekonstruktion zentraler Gefäße und simultane oder zweizeitige Resektionen von Lungenmetastasen sind Methoden, die die Resektabilität fortgeschrittener primärer und sekundärer Lebertumoren steigern. 5-Jahres-Überlebensraten von 26-46 % bei kolorektalen Lebermetastasen, 40 % bei primären Lebertumoren und ein mittleres Überleben von 42 Monaten nach Resektion von Leber- und Lungenmetastasen können dadurch erreicht werden. Schlussfolgerung: Ein interdisziplinäres Vorgehen und eine aggressive chirurgische Therapie bei primären und sekundären Lebertumoren bzw. bei proximalen Gallengangskarzinomen ermöglichen gute Langzeitergebnisse bei akzeptabler Morbidität und Mortalität.

Abstract

Background: Bilobar hepatic metastases, a small residual liver volume, de-novo and recurrent lesions, simultaneous pulmonary metastases and infiltration of vascular structures are often limiting factors in the surgical treatment of primary and secondary liver tumors. Nevertheless surgery is the “gold standard” with the chance of long-term survival, not possible to achieve with locally ablation and chemotherapy. Methods: The combination with neoadjuvant chemotherapy and radiofrequency ablation, extended liver resection after selective portal vein embolization, two-stage hepatectomy, resection and reconstruction of vascular structures in deep hypothermia and simultaneous resection of pulmonary metastases, increase the resectability even in patients with poor prognosis achieving 5-year-survival rates between 26-46 % in colorectal liver metastases, 40 % in primary liver tumors and a median survival of 42 months after resection of liver and lung metastases. Conclusion: Interdisciplinary treatment and aggressive surgical resection seem to be justified, when performed safely as a curative option.

Schlüsselwörter

neoadjuvante Chemotherapie - lokale Tumorablation - Pfortaderembolisation - zweizeitige Leberresektion - Resektion von Lungenmetastasen

Key words

neoadjuvant chemotherapy - locally ablation therapy - portal vein embolization - two-stage hepatectomy - pulmonary resection

Literatur

• 1 Abdalla E K, Hicks M E, Vauthey J N. Portal vein embolization: rationale, technique and future prospects.  Br J Surg. 2001;  88 165-175
• 2 Adam R, Bismuth H, Castaing D, Waechter F, Navarro F, Abascal A, Majno P, Engerran L. Repeat hepatectomy for colorectal cancer liver metastases.  Ann Surg. 1997;  225 51-62
• 3 Adam R, Delvart V, Pascal G, Valeanu A, Castaing D, Azoulay D, Giacchetti S, Paule B, Kunstlinger F, Ghemard O, Levi F, Bismuth H. Rescue surgery for unresectable colorectal liver metastases downstaged by chemotherapy: a model to predict long-term survival.  Ann Surg. 2004;  240 644-657
• 4 Adam R, Laurent A, Azouley D, Castaing D, Bismuth H. Two-stage hepatectomy: a planned strategy to treat irresectable liver tumors.  Ann Surg. 2000;  232 777-785
• 5 Altendorf-Hofmann A, Scheele J A. A critical review of the major indicators of prognosis after resection of hepatic metastases from colorectal carcinoma.  Surg Oncol Clin N Am. 2003;  12 165-192
• 6 Azouley D, Castaing D, Smail A, Adam R, Cally V, Laurent A, Lemoine A, Bismuth H. Resection of nonresectable liver metastases from colorectal cancer after percutaneous portal vein embolization.  Ann Surg. 2000;  231 480-486
• 7 Bakalakos E A, Kim J A, Young D, Martin Jr  E W. Determinants of survival following hepatic resection for metastatic colorectal cancer.  World J Surg. 1998;  22 399-405
• 8 Biasco G, Gallerani E. Treatment of liver metastases from colorectal cancer: what is the best approach today?.  Dig Liver Dis. 2001;  33 438-444
• 9 Bismuth H, Adam R, Levi F, Farabos C, Waechter F, Castaing D, Majno P, Engerran L. Resection of nonresectable liver metastases from colorectal cancer after neoadjuvant chemotherapy.  Ann Surg. 1996;  224 509-522
• 10 Boillot O, Delafosse B, Mechet I, Boucaud C, Pouyet M. Small-for-size partial liver graft in an adult recipient; a new transplant technique.  Lancet. 2002;  359 406-407
• 11 Cady B, Jenkins R L, Steele Jr  G D, Lewis W D, Stone M D, McDermott W V, Jessup J M, Bothe A, Lalor P, Lovett E J, Lavin P, Linehan D C. Surgical margin in hepatic resection for colorectal metastasis: a critical and improbable determinant of outcome.  Ann Surg. 1998;  227 566-571
• 12 Choti M A, Sitzmann J V, Tiburi M F, Sumetchotimetha W, Rangsin R, Schulick R D, Lillemoe K D, Yeo C J, Cameron J L. Trends in long-term survival following liver resection for hepatic colorectal metastases.  Ann Surg. 2002;  235 759-766
• 13 De Baere T, Roche A, Elias D, Lasser P, Lagrange C, Bousson V. Preoperative portal vein embolization for extension of hepatectomy indications.  Hepatology. 1996;  24 1386-1391
• 14 De Gramont A, Vignoud J, Tournigand C, Louvet C, Andre’ T, Varette C, Raymond E, Moreau S, Le Bail N, Krulik M. Oxaliplatin with high-dose leucovorin and 5-fluorouracil 48-hours continuous infusion in pretreated colorectal cancer.  Eur J Cancer. 1997;  33 214-219
• 15 Douillard J Y, Cunningham D, Roth A D, Navarro M, James R D, Karasek P, Jandik P, Iveson T, Carmichael J, Alakl M, Gruia G, Awad L, Rougier P. Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomized trial.  Lancet. 2000;  355 1041-1047
• 16 Ebata T, Nagino M, Kamiya J, Uesaka K, Nagasaka T, Nimura Y. Hepatectomy with portal vein resection for hilar cholangiocarcinoma: audit of 52 consecutive cases.  Ann Surg. 2003;  238 720-727
• 17 Ekkberg H, Tranberg K G, Andersson R, Lundstedt C, Hagerstrand I, Ranstam J, Bengmark S. Determinants of survival in liver resection for colorectal secondaries.  Br J Surg. 1986;  73 727-731
• 18 Elias D, de Baere T, Roche A, Mducreux, Leclere J, Lasser P. During liver regeneration following right portal embolization the growth rate of liver metastases is more rapid than that of the liver parenchyma.  Br J Surg. 1999;  86 784-788
• 19 Elias D, Lasser D, Rougier P. Frequency, technical aspects, results and indications of major hepatectomy after prolonged intraarterial hepatic chemotherapy for initally unresectable hepatic tumors.  J Am Coll Surg. 1995;  180 213-218
• 20 Elias D, Ouellet J F, Bellon N, Pignon J P, Pocard M, Lasser P. Extrahepatic disease does not contraindicate hepatectomy for colorectal liver metastases.  Br J Surg. 2003;  90 567-574
• 21 Esteban J M, Molla M A, Tomas C, Maldonado L. Improved detection of liver metastases with contrast-enhanced wide band harmonic imaging: comparison with CT findings.  Eur J Ultrasound. 2002;  15 119-126
• 22 Fernandez-Trigo V, Shamsa F, Sugarbaker P H. Repeat liver resections from colorectal metastasis.  Surgery. 1995;  117 296-304
• 23 Fong Y, Cohen A M, Fortner J G, Enker W E, Turnbull A D, Coit D G, Marrero A M, Prasad M, Blumgart L H, Brennan M F. Liver resection for colorectal metastases.  J Clin Oncol. 1997;  15 938-946
• 24 Fong Y, Fortner J, Sun R L, Brennan M F, Blumgart L H. Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1 001 consecutive cases.  Ann Surg. 1999;  230 309-321
• 25 Fujii Y, Shimada H, Endo I, Kamiyama M, Kamimukai N, Tanaka K, Kunisaki C, Sekido H, Togo S, Nagashima Y. Changes in clinicopathological findings after portal vein embolization.  Hepatogastroenterology. 2000;  47 1560-1563
• 26 Fusai G, Davidson B R. Management of colorectal liver metastases.  Colorectal Disease. 2003;  5 2-23
• 27 Galandiuk S, Wieand H S, Moertel C G, Cha S S, Fitzgibbon Jr  R J, Pemberton J H, Wolf B G. Patterns of recurrence after curative resection of carcinoma of the colon and rectum.  Surg Gynecol Obstet. 1992;  174 27-32
• 28 Gayowski T J, Iwatsuki S, Madariaga J R, Selby R, Todo S, Irish W, Starzl T E. Experience in hepatic resection for metastatic colorectal cancer: analysis of clinical and pathological risk factors.  Surgery. 1994;  116 703-711
• 29 Giacchetti S, Itzhaki M, Gruia G, Adam R, Zidani R, Kunstlinger F, Brienza S, Alafaci E, Bertheault-Cvitkovic F, Jasmin C, Reynes M, Bismuth H, Misset J L, Levi F. Long-term survival of patients with unresectable colorectal cancer liver metastases following infusional chemotherapy with 5-fluorouracli, leucovorin, oxaliplatin and surgery.  Ann Oncol. 1999;  10 663-669
• 30 Giovagnoni A, Martegani A, Aiani L, Ligabue G, Romagnoli R, Del Favero C. Pulse inversion ultrasonography with ultrasonography contrast media (levovist) in the evaluation of hepatic metastases.  Radiol Med. 2001;  101 111-117
• 31 Goldberg S N, Kamel I R, Kruskal J B, Reynolds K, Monsky W L, Stuart K E, Ahmed M, Raptopoulos V. Radiofrequency ablation of hepatic tumors: increased tumor destruction with adjuvant liposomal doxorubicin therapy.  AJR. 2002;  179 93-101
• 32 Goslin R, Steele Jr  G, Zamcheck M, Mayer R, MacIntyre J. Factors influencing survival in patients with hepatic metastases from adenocarcinoma of the colon and rectum.  Dis Colon Rectum. 1982;  25 749-754
• 33 Haider M A, Amitai M M, Rappaport D, O'Malley M E, Hanbridge A E, Redston M, Lockwood G A, Gallinger S. Multi-detector row CT in preoperative assessment of small (≤ 1,5 cm) liver metastases: is thinner collimation better?.  Radiology. 2002;  225 137-142
• 34 Hamazaki K, Yagi T, Inagaki M, Tanaka N, Mimura H, Orita K, Lygidakis N J. Hepatectomy under extracorporeal circulation.  Surgery. 1995;  118 98-102
• 35 Harada H, Imamura H, Miyagawa S, Kawasaki S. Fate of human liver after hemihepatic portal vein embolization: cell kinetic and morphometric study.  Hepatology. 1997;  26 1162-1170
• 36 Henderson J M, Heymsfield S B, Horowitz J, Kutner M H. Measurement of liver and spleen volume by computed tomography.  Radiology. 1981;  141 525-527
• 37 Herrera M C, Palomero M F, Macias R I, Serrano M A, Marin J J. Comparison of the effects of bischolylglycinatechloro-platinum versus cisplatin on liver regeneration after partial hepatectomy.  Anticancer Res. 1998;  18 3555-3563
• 38 Ikai I, Itai Y, Okita K, Omata M, Kojiro M, Kobayashi K, Nakanuma Y, Futagawa S, Makuuchi M, Yamaoka Y. Report of the 15^th follow-up survey of primary liver cancer.  Hepatol Res. 2004;  28 21-29
• 39 Ikai I, Yamaoka Y, Yamamoto Y, Ozaki N, Sakai Y, Satoh S, Shinkura N, Yamamoto M. Surgical intervention for patients with stage IV-A hepatocellular carcinoma without lymph node metastasis: proposal as a standard therapy.  Ann Surg. 1998;  227 433-439
• 40 Ikai I, Yamamoto Y, Yamamoto N, Terrajima H, Hatano E, Shimahara Y, Yamaoka Y. Results of hepatic resection for hepatocellular carcinoma invading major portal and / or hepatic veins.  Surg Oncol Clin N Am. 2003;  12 65-75
• 41 Ike H, Shimada H, Togo S, Yamaguchi S, Ichikawa Y, Tanaka K. Sequential resection of lung metastasis following partial hepatectomy for colorectal cancer.  Br J Surg. 2002;  89 1164-1168
• 42 Ikeda Y, Matsumata T, Utsunomiya T, Yamagata M, Takenaka K, Sugimachi K. Effect of doxorubicin on cancer cells after two-third hepatectomy in rats.  J Surg Oncol. 1995;  58 101-103
• 43 Iwatsuki S, Dvorchik I, Marsh J W, Madariaga J R, Carr B, Fung J J, Starzl T E. Liver transplantation for hepatocellular carcinoma: a proposal of a prognostic scoring system.  J Am Coll Surg. 2000;  191 389-394
• 44 Itoh T, Orba Y, Takei H, Ishida Y, Saitoh M, Nakamura H, Meguro T, Horita S, Fujita M, Nagashima K. Immunohistochemical detection of hepatocellular carcinoma in the setting of ongoing necrosis after radiofrequency ablation.  Mod Pathol. 2002;  15 110-115
• 45 Iwatsuki S, Dvorchik I, Madariaga J R, Marsh J W, Dodson F, Bonham A C, Geller D A, Gayowski T J, Fung J J, Starzl T E. Hepatic resection for metastatic colorectal adenocarcinoma: a proposal of a prognostic scoring system.  J Am Coll Surg. 1999;  189 291-299
• 46 Jaeck D, Bachellier P, Guiguet M, Boudjema K, Vaillant J C, Balladur P, Nordlinger B. Long-term survival following resection of colorectal hepatic metastases: Association Francaise de Chirurgie.  Br J Surg. 1997;  84 977-980
• 47 Jaeck D, Oussoultzoglou E, Rosso E, Greget M, Weber J C, Bachellier P. A two-stage hepatectomy procedure combined with portal vein embolization to achieve curative resection for initially unresectable multiple and bilobar colorectal liver metastases.  Ann Surg. 2004;  240 1037-1051
• 48 Johnson K, Bakhsh A, Young D, Martin Jr  T E, Arnold M. Correlating computing tomography and positron emission tomography scan with operative findings in metastatic colorectal cancer.  Dig Colon Rectum. 2001;  44 354-357
• 49 Kemeny N E, Kemeny M M, Lawrens T S. Liver metastases. In: Abeloff MD (ed). Clinical oncology. Churchill Livingstone, New York 2000; 886-921
• 50 Kokudo N, Tada K, Seki M, Ohta H, Azekura K, Ueno M, Ohta K, Yamaguchi T, Matsubara T, Nakajima T, Muto T, Ikari T, Yanagisawa A, Kato Y. Proliferative activity of intrahepatic colorectal metastases after preoperative hemi-hepatic portal vein embolization.  Hepatology. 2001;  34 267-272
• 51 Kubota K, Makuuchi M, Kusaka K, Kobayashi T, Miki K, Hasegawa K, Harihara Y, Takayama T. Measurement of liver volume and hepatic functional reserve as a guide to decision-making in resectional surgery for hepatic tumors.  Hepatology. 1997;  26 1176-1181
• 52 Kin T, Nakajima Y, Kanehiro H, Hisanaga M, Ohyama T, Nishio K, Sho M, Nagao M, Nakano H. Repeat hepatectomy for recurrent colorectal metastases.  World J Surg. 1998;  22 1087-1091
• 53 Ladurner R, Bodner G, Offner F, Krismer A, Margreiter R, Königsrainer A. Extended hepatic resection and portosystemic shunt in pigs: a model for experimental liver regeneration.  Europ Surg. 2006;  im Druck
• 54 Ladurner R, Brandacher G, Riedl-Huter C, Steurer W, Spechtenhauser B, Waldenberger P, Margreiter R, Königsrainer A. Percutaneous portal vein embolisation in preparation for extended hepatic resection of primary nonresectable liver tumours.  Dig Liv Dis. 2003;  35 716-721
• 55 Lehnert T, Knaebel H P, Duck M, Bulzebruck H, Herfarth C. Sequential hepatic and pulmonary resections for metastatic colorectal cancer.  Br J Surg. 1999;  86 241-243
• 56 Levi F, Zidani R, Misset J L. for the International Organization for Cancer Chronotherapy . Randomised multicentre trial of chronotherapy with oxaliplatin, fluorouracil, and folinic acid in metastatic colorectal cancer.  Lancet. 1997;  350 681-686
• 57 Llovet J M, Bustamante J, Castells A, Villana R, Ayuos Mdel C, Sala M, Bru C, Rodes J, Bruix J. Natural history of untreated nonsurgical hepatocellular carcinoma: rationale for the design and evaluation of therapeutic trials.  Hepatology. 1999;  29 62-67
• 58 Makuuchi M, Thai B K, Takayasu K, Takayama T, Kosuge T, Gunnven P, Yamazaki S, Hasegawa H, Ozaki H. Preoperative portal vein embolization to increase safety of major hepatectomy for hilar bile duct carcinoma: a preliminary report.  Surgery. 1990;  107 521-527
• 59 Man K, Fan S T, Lo C M, Liu C L, Fung C W, Liang T B, Lee K W, Tsui H T, Ng I O, Zhang Z W, Wong J. Graft injury in relation to graft size in right lobe live donor liver transplantation: a study of hepatic sinusoidal injury in correlation with portal hemodynamics and intragraft gene expression.  Ann Surg. 2003;  237 256-264
• 60 Man K, Lo C M, Ng I O, Wong Y C, Qin L F, Fan S T, Wong J. Liver transplantation in rats using small-for-size grafts. A study of hemodynamic and morphological changes.  Arch Surg. 2001;  136 280-285
• 61 Mazzaferro V, Regaglia E, Doci R, Andreola S, Pulvirenti A, Bozzetti F, Montalto F, Ammatuna M, Morabito A, Gennari L. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis.  N Engl J Med. 1996;  334 693-699
• 62 Minagawa M, Makuuchi M, Kubota K, Kondo Y. Intraoperative three dimensional ultrasound visualization of liver vasculature.  Hepatogastroenterology. 2004;  51 1448-1450
• 63 Minagawa M, Makuuchi M, Takayama T, Ohtomo K. Selection criteria for hepatectomy in patients with hepatocellular carcinoma and portal vein tumor thrombus.  Ann Surg. 2000;  233 379-384
• 64 Minagawa M, Makuuchi M, Torzilli G, Takayama T, Kawasaki S, Kosuge T, Yamamoto J, Imamura H. Extension of the frontiers of surgical indications in the treatment of liver metastases from colorectal cancer: long-term results.  Ann Surg. 2000;  231 487-499
• 65 Moertel C G. Chemotherapy for colorectal cancer.  N Engl J Med. 1994;  330 1136-1139
• 66 Nagino M, Kamiya J, Nishio H, Ebata T, Arai T, Nimura Y. Two hundred forty consecutive portal vein embolizations before extended hepatectomy for biliary cancer. Surgical outcome and long-term follow-up.  Ann Surg. 2006;  243 364-370
• 67 Neeleman N, Andersson R. Repeated liver resection for recurrent liver cancer.  Br J Surg. 1996;  83 893-901
• 68 Neilsen J, Balslev I, Jensen H E. Carcinoma of the colon with liver metastases: operative indications and prognosis.  Acta Chir Scand. 1971;  137 463-465
• 69 Nimura Y, Hayakawa N, Kamiya J, Maeda S, Kondo S, Yasui A, Shionoya S. Hepatopancreatoduodenectomy for advanced carcinoma of the biliary tract.  Hepatogastroenterology. 1991;  38 170-175
• 70 Nimura Y, Kamiya J, Kondo S, Nagino M, Uesaka K, Oda K, Sano T, Yamamoto H, Hayakawa N. Aggressive preoperative management and extended surgery for hilar cholangiocarcinoma: Nagoy experience.  J Hepatobiliary Pancreat Surg. 2000;  7 155-162
• 71 Nishizaki T, Ikegami T, Hiroshige S, Hashimoto K, Uchiyama H, Yoshizumi T, Kishikawa K, Shimada M, Sugimachi K. Small graft for living donor liver transplantation.  Ann Surg. 2001;  233 575-580
• 72 Nordlinger B, Guiguet M, Vaillant J C, Balladur P, Boudjema K, Bachellier P, Jaeck D. Surgical resection of colorectal carcinoma metastases to the liver: a prognostic scoring system to improve case selection based on 1 568 patients.  Cancer. 1996;  77 1254-1262
• 73 Nordlinger B, Vaillant J C, Guiguet M, Balladur P, Boudjema K, Bachellier P, Jaeck D. Survival benefit of repeat liver resections for recurrent colorectal metastases: 143 cases.  J Clin Oncol. 1994;  12 1491-1469
• 74 Panis Y, Ribeiro J, Chretien Y, Nordlinger B. Dormant liver metastases: an experimental study.  Br J Surg. 1994;  19 221-233
• 75 Picardo A, Karpoff H M, Ng B, Lee J, Brennan M F, Fong Y. Partial hepatectomy accelerates local tumor growth: potential roles of local cytokine activation.  Surgery. 1998;  124 57-64
• 76 Registry of hepatic metastases . Resection of the liver for colorectal carcinoma metastases: multi-institutional study of indication for resection.  Surgery. 1988;  103 278-288
• 77 Rougier P, Van Cutsem E, Bajetta E, Niederle N, Possinger K, Labianca R, Navarro M, Morant R, Bleiberg H, Wils J, Awad L, Herait P, Jacques C. Randomised trial of irinotecan versus fluorouracil by continuous infusion after fluorouracil failure in patients with metastatic colorectal cancer.  Lancet. 1998;  352 1407-1412
• 78 Ruers T J, Langenhoff B S, Neeleman N, Jager G J, Strijk S, Wobbes T, Corstens F H, Oyen W J. Value of positron emission tomography with (F-18) fluorodeoxyglucose in patients with colorectal liver metastases: a prospective study.  J Clin Oncol. 2002;  20 388-395
• 79 Sahin M, Tekin S, Aksoy F. The effects of splenic artery ligation in an experimental model of secondary hypersplenism.  J R Coll Surg Edinb. 2000;  45 148-152
• 80 Sato Y, Yamamoto S, Oya H, Nakatsuka H, Tsukahara A, Kobayashi Y, Watanabe T, Hatakeyama K. Splenectomy for reduction of excessive portal hypertension after adult living-related donor liver transplantation.  Hepatogastroenterology. 2002;  49 1652-1655
• 81 Scheele J, Stangl R, Altendorf-Hofmann A, Grube T, Hohenberger W, Stangl R, Schmidt K. Resection of colorectal metastases.  World J Surg. 1995;  19 59-71
• 82 Sebagh M, Adam R, Lemoine A. et al . Evaluation histologique et biochimique de la toxicité hepatique d'une chimiotherapie systematique.  Gastroenterol Clin Biol. 1996;  20 A 1
• 83 Selzner M, Hany T F, Wildbrett P, McCormack L, Kadry Z, Clavien P. Does the novel PET / CT imaging modality impact on the treatment of patients with metastatic colorectal cancer of the liver?.  Ann Surg. 2004;  240 1026-1034 , discussion 1035-1036
• 84 Shah S, Haddad R, Al-Sukhni W, Kim R D, Greig P, Grant D R, Taylor B R, Langer B, Gallinger S, Wei A C. Surgical resection of hepatic and pulmonary metastases form colorectal carcinoma.  J Am Coll Surg. 2006;  202 468-475
• 85 Shigeta H, Nagino M, Kamiya J, Uesaka K, Sano T, Yamamoto H, Hayakawa N, Kanai M, Nimura Y. Bacteremia after hepatectomy: an analysis of single center, 10-year experience with 407 patients.  Langenbecks Arch Surg. 2002;  387 117-124
• 86 Shimada H, Tanaka K, Masui H, Nagano Y, Matsuo K, Kijama M, Ichikawa Y, Ike H, Ooki S, Togo S. Result of surgical treatment for multiple (> 5 nodules) bilobar-hepatic metastases from colorectal cancer.  Langenbecks Arch Surg. 2004;  389 114-121
• 87 Shirabe K, Takenaka K, Gion T, Fujiwara Y, Shimada M, Yanaga K, Maeda T, Kajiyama K, Sugimachi K. Analysis of prognostic risk factors in hepatic resection for metastatic colorectal carcinoma with special reference to the surgical margin.  Br J Surg. 1997;  84 1077-1080
• 88 Sica G T, Ji H, Ros P R. Computed tomography and magnetic resonance imaging of hepatic metastases.  Clin Liver Dis. 2002;  6 165-179
• 89 Slooter G D, Marquet R J, Jeekel J, Ijzermans J NM. Tumor growth stimulation after partial hepatectomy can be reduced by treatment with tumor necrosis factor alpha.  Br J Surg. 1995;  82 129-132
• 90 Soyer P, Roche A, Elias D, Levesque M. Hepatic metastases from colorectal cancer: influence of hepatic volumetric analysis on surgical decision-making.  Radiology. 1992;  184 695-697
• 91 Taylor M, Forster J, Langer B, Taylor B R, Greig P D, Mahut C. A study of prognostic factors for hepatic resection for colorectal metastases.  Am J Surg. 1997;  173 467-471
• 92 Troisi R, Cammu G, Militerno G, De Baerdemaeker L, Decruyenaere J, Hoste E, Smeets P, Colle I, Van Vlierberghe H, Petrovic M, Voet D, Mortier E, Hesse U J, De Hemptinne B. Modulation of portal graft inflow: a necessity in adult living-donor liver transplantation.  Ann Surg. 2003;  237 429-436
• 93 Tuttle T M, Curley S A, Roh M S. Repeat hepatic resection as effective treatment of recurrent colorectal liver metastases.  Ann Surg Oncol. 1997;  4 125-130
• 94 Ueno S, Kobayashi Y, Kurita K, Tanabe G, Aikou T. Effect of prior portosystemic shunt on early hepatic hemodynamics and sinusoids following 84 % hepatectomy in dogs.  Res Exp Med. 1995;  195 1-8
• 95 Ueno H, Mochizuki H, Hatsuse K, Hase K, Yamamoto T. Indications for treatment strategies of colorectal liver metastases.  Ann Surg. 2000;  231 59-66
• 96 Usta E, Aebert H, Ladurner R, Ziemer G, Königsrainer A. Extended right hemihepatectomy with extracorporeal circulation for liver metastases invading the inferior vena cava and right atrium.  J Surg Oncol. 2006;  94 434-436
• 97 Vauthey J N, Chaoui A, Do K A, Bilimoria M M, Fenstermacher M J, Charnsangave Hicks M, Alsfasser G, Lauwers G, Hawkins I F, Caridi J. Standardised measurement of the future liver remnant prior to extended liver resection: methodology and clinical associations.  Surgery. 2000;  127 512-519
• 98 Weese J L, Ottery F D, Emoto S E. Do operations facilitate tumor growth? An experimental model in rats.  Surgery. 1986;  100 273-277
• 99 Wood C B, Gillis C R, Blumgart L H. A retrospective study of the natural history of patients with liver metastases from colorectal cancer.  Clin Oncol. 1976;  2 285-288
• 100 Yamada R, Kishi K, Sato M, Sonomura T, Nishida N, Tanaka K, Shioyama Y, Terada M, Kimura M. Transcatheter arterial chemoembolization (TACE) in the treatment of unresectable liver cancer.  World J Surg. 1995;  19 795-800
• 101 Yamamoto H, Nagino M, Kamiya J, Hayakawa N, Nimura Y. Surgical treatment for colorectal liver metastases involving the paracaval portion of the caudate lobe.  Surgery. 2005;  137 26-32