Surgical treatment of liver metastases from colorectal cancer

The experience with 28 patients undergoing hepatic resection for metastases from colorectal cancer is reported. In 15 cases the metastases were synchronous, in 13 metachronous, appearing 12 to 60 months after surgery of primary cancer. Six patients underwent right lobectomy, 2 left lobectomy, 9 left lateral segmentectomy, 6 right wedge resection and 2 bilateral wedge resection. In 20 cases the lesions were solitary, in 8 multiple. Overall operative mortality was 14.2%. Mean survival for synchronous metastases was 16 months with 3 patients living beyond 12 months, and 26 months for metachronous metastases with 4 patients living beyond 12 months. The obtained results are analyzed on the basis of staging of primary cancer, of the metastatic disease and type of resection, examining the morbidity and cause of long term mortality. It is evidenced that, even if correct pre- and intraoperative staging of metastatic disease is impossible, an aggressive surgical approach is the treatment of choice in surgically resectable liver metastases from colorectal cancer.