Liver Metastases from Colorectal Cancer: Present Surgical Approach

Antonino Cavallari, Marco Vivarelli, Roberto Bellusci, Roberto Montalti, Nicola De Ruvo, Alessandro Cucchetti, Antonio De Vivo, Emilio De Raffele, MariaCristina Salone, Giuliano La Barba

Research output: Contribution to journalArticlepeer-review

Abstract

Background/Aims: New developments in surgical techniques and strategies are modifying the indications to resection of liver metastases. Methodology: From January 1986 to December 2000, 246 consecutive patients with colorectal liver metastases underwent curative hepatic resection. Surgical strategies included simultaneous resection of primary and metastatic colorectal tumor, re-resection of colorectal liver recurrences, two-stage resection and resection of the inferior vena cava when involved by the tumor. Disease-free survival in relation to clinical, pathological and surgical factors was retrospectively assessed with univariate and multivariate analyses. Results: The overall operative mortality was 0.8%. The 1-, 3- and 5-year disease-free survival rates were 75%, 47% and 40%, respectively. Tumors larger than 7 centimeters, multiple lesions, tumors involving more than 2 segments and those requiring major hepatectomy had a worse prognosis at univariate analysis. A size of the tumor above 7 centimeters was the only independent prognostic factors at multivariate analysis. Two-stage and inferior vena cava resection increased operability; re-resection of recurrent colorectal secondaries prolonged survival. Conclusions: Resection of colorectal liver metastases is safe and effective; it should be considered the treatment of choice for this disease and proposed even for advanced lesions. Counseling of the hepatobilary surgeon should be asked for once a liver secondary is detected in the preoperative work-up of a colorectal cancer.

Original languageEnglish
Pages (from-to)2067-2071
Number of pages5
JournalHepato-Gastroenterology
Volume50
Issue number54
Publication statusPublished - Nov 2003

Keywords

  • Colorectal cancer
  • Liver metastases
  • Surgical treatment

ASJC Scopus subject areas

  • Gastroenterology

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