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Clinical significance of post-hepatectomy hepatic failure in patientswith liver metastases from colorectal cancer
Ann Hepatobiliary Pancreat Surg 2018 May;22(2):93-100
Published online May 31, 2018
Copyright © 2018 Ann Hepatobiliary Pancreat Surg.

Hye-Sung Jo, Dong-Sik Kim, Sung-Won Jung, Young-Dong Yu, Sae-Byeol Choi, Wan-Bae Kim, Hyung-Joon Han, and Tae-Jin Song

Division of Hepatobiliary, Pancreas Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine, Seoul, Korea
Received November 28, 2017; Revised February 4, 2018; Accepted February 6, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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 re-currence-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 be-tween 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. (Ann Hepatobiliary Pancreat Surg 2018;22:93-100)
Keywords : Liver metastasis from colorectal cancer; Hepatectomy; International Study Group of Liver Surgery; Hepatic failure