RESECTION OF LIVER METASTASES FROM COLORECTAL-CANCER - INDICATIONS AND RESULTS

PURPOSE: This study was undertaken to determine the indications for an d value of liver resection for metastases from colorectal cancer. METH ODS: From 1978 through 1991, 66 patients were operated on for liver me tastases from colorectal cancer. AU patients had had a curative resect ion of their colorectal cancer. Forty resections of the liver were maj or anatomic resections. RESULTS: Five patients died in the postoperati ve period. All resections were intended to be curative, but in 16 of t he patients the resection became noncurative. None of these patients l ived more than two years after liver resection. Fifty patients with a curative resection had a three-year survival rate of 36 percent, posto perative death included. Recurrence in the liver was observed in 30 pa tients (60 percent) from 3 to 33 (median, 11) months after the liver r esection. Four patients had repeated resections performed. Two of them are alive without recurrences 34 and 60 months after the first liver resection, respectively. The difference in survival between curative a nd noncurative liver resection was highly significant (P = 0.01). CONC LUSIONS: Sex, age, Dukes stage of primary colorectal cancer, synchrono us or metachronous appearance of metastases, or number of metastases c ould not predict long-term prognosis. The only factors of predictive v alue were tumor size less than 4 cm in diameter, a free resection marg in, and no extrahepatic tumor. If it is possible to do a curative rese ction, there should be few contraindications against liver surgery as it is the only treatment that can demonstrate long-term survival for a pproximately one-third of the patients, and it is the only possibility of a cure.