PATTERN OF RECURRENCE AFTER HEPATIC RESECTION FOR COLORECTAL METASTASES

Between 1978 and 1989, 159 patients with liver metastases from colorec tal cancer underwent hepatic resection. Of 134 patients in whom metast ases were confined to the liver, 109 had tumours removed completely wi th histologically negative resection margins. Two patients died in hos pital. Ultrasonographically guided partial resection was performed in 80 patients, lateral segmentectomy in seven and lobectomy in 22. The 5 -year survival rate of patients undergoing potentially curative resect ion was 47.9 per cent. Patients with metachronous tumours showed a sig nificantly better prognosis than those with synchronous lesions in bot h univariate (P < 0.01) and multivariate (P = 0.01) analysis. During a median follow-up of 35.4 months, 64 patients developed recurrence, in cluding 34 in the liver, 20 in the lung and 12 in the abdominal cavity . Of those with hepatic recurrence, ten patients developed tumours at the initial resection bed, seven in the same lobe, five in the contral ateral lobe and 12 in both lobes. Ultrasonographically guided partial liver resection did not increase the risk of hepatic recurrence.