Major hepatic resection for secondary malignant tumours of the liver--case studies from eastern Nigeria

Major hepatic resection (MHR) was performed in three patients with secondary malignant liver tumour (SMLT). MHR and extirpation of the primary cancer were done synchronously. There were two males and one female age 49, 52 and 65 years respectively. All were in liver functional Class B (Child's). Right hepatectomy and right hemicolectomy were done in one patient; while the others required: (1) left hepatectomy and middle colectomy in one patient; (2) left hepatectomy, middle colectomy total gastrectomy, splenectomy and middle colectomy in continuity in the last patient. They all tolerated the surgery and were discharged 16 to 24 days after surgery. Histology was adenocarcinoma in two patients and carcinoid tumour in one patient. One patient died 14 months after resection from recurrent tumour and liver failure. The other two patients have been followed up for 21 months and nine months. They are well and show no evidence of tumour recurrence. It is concluded that MHR is indicated in selected patients with SMLT. The short term and medium term results are better than the usual palliative management but case selection should be on criteria enunciated below.