Hepatic resection of metastatic colorectal carcinoma: a ten-year experience

Nineteen patients have undergone partial hepatectomy for metastatic colorectal carcinoma at UCLA during the past ten years, including five trisegmentectomies (TS), eight lobectomies (L), and six segmentectomies (SG), with only one (5.3%) mortality. Twelve lesions were solitary (S) and seven multiple (M). Mean survival is 27.4 months, with three patients surviving over five years and one nearly eight years. Better mean survival exists for S (33.2 months) compared with M (15.8 months) lesions; for lesser resections: SG (44.7 months), compared with L (24.3 months) and TS (11.0 months); and for those with delayed appearance of hepatic metastases: beyond two years (40.5 months), less than one year (24.8 months), and synchronous (23.1 months). Survival figures should improve, as none of the 12 surviving patients have evidence of recurrent disease and many have short follow-up. This experience defends aggressive surgical treatment of resectable colorectal carcinoma metastatic to liver, because systemic therapy is markedly less effective.