HEPATIC RESECTION FOR METASTATIC COLORECTAL-CANCER RESULTS IN CURE FOR SOME PATIENTS

Objectives: To determine the long-term disease-free and overall surviv als for patients undergoing hepatic resection for colorectal cancer me tastases and to define significant predictors of improved patient surv ival. Design: Retrospective review. Setting: Single tertiary care cent er. Patients: Two hundred eighty consecutive patients underwent hepati c resection for colorectal cancer metastases at the Mayo Clinic from 1 960 to 1987. Fifty patients alive at the completion of the study had a mean follow-up of 11.3 years (median, 121 months). Main Outcome Measu res: Disease-free interval following initial hepatic resection and dea th. Results: The overall 5-year survival of the 280 patients was 27%. Twenty-eight patients were alive at 10 years from the time of hepatic resection, and the 10-year actuarial survival was 20%. Only 2 patients alive and free of disease at 5 years had recurrent disease. For all o ther patients who were free of disease more than 5 years after hepatic resection and died, the cause of death was not cancer related. No pat ient characteristics or features of the primary tumor affected surviva l. Clinical presentation of metastatic disease, configuration of hepat ic lesions, the presence of extrahepatic lymph node involvement, and t he existence of resectable extrahepatic disease significantly affected long-term patient survival. Need for perioperative blood product tran sfusion was associated with a lower probability of long-term survival. Conclusion: Disease-free patient survival beyond 5 years from surgica l resection of colorectal cancer metastases to the liver represents pa tient cure in nearly all instances.