Major Hepatic Resections for Metastatic Colorectal Cancer

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Abstract
In 1973, a study of patients with resectable hepatic metastases from colorectal cancer compared survival of 60 patients who had metastases removed with survival of 60 patients with similar lesions that had been biopsied only. It was concluded that excision of small, apparently solitary metastatic lesions could be justified on the basis of the low operative risk and prolonged survival. The risks and benefits of resection of larger metastatic lesions could not be determined because only 7 of those patients had lesions so large as to require major hepatic resection. To evaluate size as a determinant of prognosis after resection, to those 7 patients 27 others were added who were managed since 1973 by major hepatic resection of larger metastases. There were 2 hospital deaths. Of the 32 surviving patients, 82% lived 1 yr or more, 77% 18 mo. or more, 58% 2 yr or more and 41% 3 yr or more postoperatively. Three patients are living 10-22 yr after resection. From a critical analysis of the duration and quality of life of surviving patients, it is concluded that at least 20% and perhaps 30% of these patients were benefited by major hepatic resection of their large hepatic metastasis.

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