TREATMENT OF LIVER METASTASES FROM COLORECTAL-CANCER

197 cases of distant metastases from colorectal cancer (Dukes A, B, C) were diagnosed in 664 patients after curative resection of the primar y tumor. Extrahepatic progress could be excluded in 98 of 142 patients with liver metastases. These 98 patients were allocated to surgical t reatment (n = 17), intraarterial chemotherapy (n = 24), transarterial chemo-embolization (n = 20), systemic chemotherapy (n = 10) and syptom atic therapy (n = 27) depending on the extent and localization of the disease within the liver and the patients' general condition. Curative success in 12 of 17 patients with a 5-year survival of 47 % was achie ved by the careful selection of patients for surgical treatment. Prolo nged median survival after systemic chemotherapy (13 months), intraart erial chemotherapy metastases (12 months) compared with the survival o f patients with a symptomatic treatment only (median 11 months) could not be demonstrated, in spite o local therapeutic effects (intraarteri al chemotherapy response rate 42 %, transarterial chemoembolization mo rphologic response 82 %). Effective postoperative diagnostic screening determines the percentage of potential curative surgical treatment; n onsurgical approaches failed to demonstrate prolonged survival.