Hepatic resection of metastatic colorectal carcinoma: a ten-year experience
S. E. Logan, S. J. Meier, K. P. Ramming, D. L. Morton and W. P. Longmire Jr
Nineteen patients have undergone partial hepatectomy for metastatic
colorectal carcinoma at UCLA during the past ten years, including five
trisegmentectomies (TS), eight lobectomies (L), and six segmentectomies
(SG), with only one (5.3%) mortality. Twelve lesions were solitary (S) and
seven multiple (M). Mean survival is 27.4 months, with three patients
surviving over five years and one nearly eight years. Better mean survival
exists for S (33.2 months) compared with M (15.8 months) lesions; for
lesser resections: SG (44.7 months), compared with L (24.3 months) and TS
(11.0 months); and for those with delayed appearance of hepatic metastases:
beyond two years (40.5 months), less than one year (24.8 months), and
synchronous (23.1 months). Survival figures should improve, as none of the
12 surviving patients have evidence of recurrent disease and many have
short follow-up. This experience defends aggressive surgical treatment of
resectable colorectal carcinoma metastatic to liver, because systemic
therapy is markedly less effective.