Results of surgical excision of one to 13 hepatic metastases in 98 consecutive patients
J. P. Minton, W. B. Hamilton, A. Sardi, C. Nieroda, B. Sickle-Santanello and P. J. O'Dwyer
Department of Surgery, Ohio State University College of Medicine, Columbus 43210.
Metastatic carcinoma to the liver is generally considered to be associated
with a poor prognosis, with five-year survival of only 20% to 30% after
resection of solitary lesions. Ninety-eight consecutive patients underwent
the surgical removal of one to 13 metastatic lesions from the liver. A
rising carcinoembryonic antigen level was considered an indication for
reexploration. All gross tumor was removed in every patient; 66 had more
than one metastasis. Survival was unexpectedly high: 91 of 98 were alive at
12 months, 50 (70%) of 71 at 13 to 24 months, 23 (66%) of 36 at 25 to 36
months, 14 (74%) of 19 at 37 to 48 months, six (60%) of ten at 49 to 60
months, four (80%) of five at 61 to 72 months, and two (50%) of four 73 to
84 months after resection of multiple liver metastases. The procedure
appears to be a safe and, in some patients, beneficial surgical technique
for the removal of multiple hepatic metastases.