Recent Experience in Hepatic Resection for Metastatic Colorectal Cancer

Abstract

To clarify recent results of hepatic resection for metastatic colorectal cancer treated by National Cancer Center Hospital from 1984 to 1991, the relationship between clinicopathological background and survival, pattern of recurrence after hepatic resection, and the effectiveness of hepatic arterial infusion for adjuvant therapy were examined. Patients : One hundred thirty-four patients with hepatic metastases due to colorectal cancer treated by curative resection were analyzed. Results : In univariate analysis, lymph node status (p<0.0001), disease-free intervals (p=0.049), extent of liver involvement (p=0.018), and microscopic positive margin (p=0.004) were significant prognostic factors. Cox's proportional hazards model revealed that only lymph node status was an independent predictor of suvival (p=0.0002). After curative hepatic resection, recurrence was observed in 96 patients (72%) and recurrence in the liver was most frequent (54%). Thirty patients were treated by repeat hepatectomy, and 10 patients survived longer than 5 years. The effectiveness of hepatic arterial infusion for adjuvant therapy were unclear. Conclusion : Prevention of liver metastases, detection of novel risk factors, and establishment of new treatment modality are essential for improving the prognosis after hepatic resection for metastatic colorectal cancer.