[Liver resection of hematogenous and infiltrating metastases]

Of a total of 245 resections for hepatic metastases 124 operations were performed for hematogenic metastases and 36 for infiltrating metastases in continuity with the primary tumour. This group of so-called "major hepatic resections" is analysed. The series comprises 83 male and 77 female patients, mean age 62.2 years. There were 85 resections of the right lobe (39 of those with intrahepatic extension to the left), 45 right) and 30 atypical hepatectomies (at least bisegmentectomies). Hematogenic hepatic metastases: 80 resections of hepatic metastases following colorectal carcinoma, 15 following cancer of the stomach and esophagus, 12 after non-gastrointestinal malignant tumours, 4 resections after unknown primary cancer (44% solitary, 32% monolobar multiple, and 24% bilateral metastases); synchronous operations were performed in 32% of the patients, in 19% so-called interval surgery (mean 7.4 weeks), and in 49% metachrone surgery (mean 30 weeks). During 1983 and 1985 our morbidity rate amounted to 10% and the letality rate to 7%, as compared to 17% morbidity and 15% letality in the period 1965-1983. In both periods, septic postoperative complications outnumbered all other causes. The mean survival rate after colorectal carcinoma was 20 months, after non-gastro-intestinal malignant growth 19 months, after carcinoma of the stomach as well as after malignant biliary tract diseases 5 months. The three-year survival rate of colorectal carcinoma amounts to 30%, the five year survival rate to 15% including all metastatic stages. The results of interval and metachrone resections in forms of survival rates are clearly better than the results of synchronous resections with a mean survival time of five months.(ABSTRACT TRUNCATED AT 250 WORDS)