Current Surgical Therapy of Hepatic Colorectal Metastasis

Abstract

Summary: Background: Liver resection represents the only cure for patients with hepatic metastases from colorectal cancers. Methods: The discussion will address which patients should be considered for hepatic resection, what are the appropriate diagnostic modalities to employ, and what are the hallmarks of surgical therapy. The biologic determinants of recurrence as the basis for rational patient selection for hepatectomy will be addressed. This review will then concentrate on recent data guiding adjuvant therapy, and emerging developments for staging. Results: Median survival of patients after liver resection for hepatic metastases is on the order of 40 months (45, 93, 105), five‐year survival is 30 % – 40 %, and ten‐year survival approximately 20 %. Operative mortality at most major centers is uniformly less than 5 %. Conclusions: These comparative results have made any random‐assignment trial of resection versus nonresectional approach unethical and resection the standard of care.

Laparoscopic Hepatectomy for Hepatic Colorectal Metastases – A Retrospective Comparative Cohort Analysis and Literature Review

“…Several studies have shown that an untreated disease is rapidly fatal, with a median survival period of 5–10 months. Patients with limited liver metastases, when left untreated, had 1-, 3-, and 5-year survival rates of 77%, 14%–23%, and 2%–8%, respectively [18]–[19]. Such patients are now considered candidates for resection.…”