RESECTION VERSUS RESECTION COMBINED WITH ADJUVANT PREOPERATIVE AND POSTOPERATIVE CHEMOTHERAPY - IMMUNOTHERAPY FOR METASTATIC COLORECTAL LIVER-CANCER

Forty patients with metastatic liver disease from colorectal carcinoma are presented in this study. Patients were randomly assigned to two g roups: Group A (20 patients) who had liver resection and Group B (20 p atients) who had liver resection combined with post-operative locoregi onal immuno- therapy + chemotherapy. Thus, during the first year follo wing surgery, they have four courses of targeted loco-regional transar terial chemotherapy-immunotherapy, two courses during the second year and one course during the third year. Two patients died, one in each g roup, during the first 30 postoperative days. Survival in Group A (19 surviving patients) ranged from 4 to 25 months, mean 11 months. Eight (8) patients had intrahepatic recurrence of the disease and 11 are sti ll alive and free of disease. Of those with intrahepatic recurrence, t hree (3) patients died 15, 15 and 17 months following surgery of cause s related to the disease. In Group B (19 surviving patients), survival ranged from 3 to 30 months, mean 20 months. At present, all 19 patien ts are alive and free of disease (p < 0.001). None has had intrahepati c recurrence (p < 0.001). On the basis of present results, liver resec tion supplemented with postoperative targeted transarterial locoregion al immunotherapy-chemotherapy is associated with optimal results. It i s highly recommended as the procedure of choice in dealing with patien ts operated upon for metastatic liver disease due to colorectal carcin oma.