RESECTION OF LIVER METASTASES OF COLORECTAL-CARCINOMA - CLAIM AND REALITY

Results of resection of potentially operable liver metastases from colorectal carcinomas were evaluated by analysis of 50 publications between 1985 and 1990, as well as own datas (88 patients). Average 1, 3 and 5-year survival rates without treatment were 71 +/- 14%, 18 +/- 10% and 3 +/- 4%, respectively. The extent of metastasization at the time of diagnosis was the decisive prognostic factor. After resection of metastases 80 +/- 21% of patients survived for 1 year, 43 +/- 12% for 3 years and 28 +/- 11% for 5 years. But only a small group of patients, those with single and small metastasis, limited to one liver lobe and without extrahepatic tumour deposits, clearly profited from resection, as long as this could be accomplished with a wide enough margin of safety. Studies on growth characteristics of metastases suggest that in a large proportion of the remaining patients the natural history of the disease is not significantly changed by the operation.