Hepatic resection for metastatic colorectal carcinoma. William Beaumont Hospital experience

Eleven hepatic resections have been performed at William Beaumont Hospital between April 1979 and April 1983 for metastatic colorectal carcinoma. Eight lesions were metachronous, and three were synchronous. All lesions except three metachronous lesions were solitary nodules. Patients who were found to have metachronous lesions were initially evaluated because of rising carcinoembryonic antigen (CEA) levels. One postoperative death occurred (9% mortality). All patients with synchronous lesions have since died for a mean survival of 15.2 months. The mean survival for patients with metachronous lesions, excluding the postoperative mortality, was 15.4 months (range, 4.1-30.7 months). The 1-year and 2-year actuarial survival rates are 79 per cent and 33 per cent. Five patients are alive, and three are free of clinical disease; therefore survival is expected to improve. In conclusion, rising CEA levels can be used to detect patients with metachronous lesions. The actuarial data support resectional therapy for metastatic colorectal carcinoma of the liver in carefully selected patients.