FATTORI PROGNOSTICI E RISULTATI A DISTANZA NELLA TERAPIA CHIRURGICA DELLE METASTASI EPATICHE DA CARCINOMA COLO-RETTALE

Hepatic resection of colo-rectal metastases, by strictly oncological criteria, does not seem to be a logical approach but, in practice, as reported in the literature proved to have a significant therapeutic value with a 5-year actuarial survival of about 25-30%. The Authors retrospectively analyzed the records of 44 patients operated on for liver resection of single or multiple metastases from colo-rectal cancer in their surgical Department from 1970 to 1988. Twenty-nine were typical hepatic resections and 15 were atypical wedge excisions of the tumor; in all the cases oncological radicality was respected in performing the resection at least at 1 centimeter far from the neoplastic lesion. Perioperative mortality was 7%. Five years actuarial survival was 27%. Single metastases showed a significant better survival (61% at 5 years) than multiple (respectively 18% and 0% for patients with 2-3 nodules and more than 3 nodules). Patients with B-Dukes lesions had significantly improved prognosis 5 years after the hepatic resection (58%) in respect with the patients in stage C or with synchronous metastases. Resection of liver metastases from colo-rectal cancer seems to be a real therapeutic option in patients with single nodule and/or in B-Dukes stage.