[Surgical treatment of hepatic metastases]

355 patients with hepatic metastases were followed between 1970 and 1984 at the Hôpital Paul Brousse. 132 cases were of colonic origin: 32 were treated by means of hepatic resection (including 5 metastasectomies), 7 by intra-hepatic anastomosis and 5 by devascularisation. The other 88 patients did not receive any surgical treatment. In 148 of the other 233 patients, the metastases were of non colonic gastro-intestinal or rectal origin and in the remaining 75 cases the metastases were derived from another site. 12 patients were treated by hepatic resection, 6 by devascularisation, 2 by intra-hepatic anastomosis and 2 by intubation of the bile ducts. One patient (0.5 per cent) died during the post-operative period following these operations. The long term survival was 73 per cent at 1 year and 29 per cent at 3 years. In conclusion, some patients are definitely cured by hepatic resection, although these patients cannot be predicted. For this reason, the surgeon's role consists of trying to decrease as much as possible the operative risk and to propose this type of treatment to all patients in which it may be beneficial.