Surgery for synchronous hepatic metastases of colorectal cancer

Over the last 10 years 32 patients have had synchronous hepatic metastases from colorectal cancer treated surgically in this unit. As a general policy the metastases were resected 3-4 months after resection of the primary tumour. At the end of this interval a thorough assessment was made for recurrent local, regional or extrahepatic metastatic disease before making a decision to perform liver resection. Eighteen patients had a conventional liver resection (13 major liver resections, 5 limited liver resections) and 14 patients had an atypical liver resection (metastasectomy). Patients were followed at 4 monthly intervals after operation using ultrasonography and CEA determination. The operative mortality (within 60 days) was zero. Twenty-six patients (81%) had a totally uncomplicated postoperative course. The period of hospitalization was 14 +/- 2 days. Two patients had a second liver resection at a later date on account of tumour recurrence. The survival rates at 1, 2 and 3 years were 84%, 58% and 33% respectively. These results confirm that synchronous hepatic metastases from colorectal cancer can be resected with minimal morbidity and mortality and that worthwhile improvements in life expectancy result.