Skip to main content
PMC home page
Annals of Surgery logoLink to Annals of Surgery
. 1985 Feb;201(2):204–209. doi: 10.1097/00000658-198502000-00012

Major hepatic resection for metachronous metastases from colon cancer.

B Cady, W V McDermott
PMCID: PMC1250642  PMID: 3970601

Abstract

Hepatic resection of metastatic colorectal cancer is being performed with increasing frequency. Reports describe wide variations in survival after resection of solitary of multiple metastases. In 23 consecutive patients having major hepatic resection for metachronous metastases from colorectal cancers, 18 patients had one, two, or three metastases and five had four or more individual metastases; the cure rate of one, two, or three metachronous metastases was comparable to reports of resected solitary simultaneous metastases. The median maximum diameter of metastases in patients both surviving and dead was 7 cm. Features separating surviving from dead patients were resection margins of at least 1 cm and fewer than four metastatic nodules. All patients with four or more hepatic metastases died of disease, 80% with further liver metastases. Only three of 18 (17%) patients with one, two, or three metastases developed further hepatic lesions. This study suggests that the biology of the hepatic metastatic disease is paramount; timing of the hepatic resection is of little importance. Delayed resection of suitable biologic situations does not impair survival opportunities, and early resection of inappropriate biologic situations with more than three hepatic metastases does not improve survival. Therefore, programs of early detection with the use of carcinoembryonic antigen (CEA) screening or "second look" operations will not increase cure rates.

Full text

PDF
209

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adson M. A., Van Heerden J. A. Major hepatic resections for metastatic colorectal cancer. Ann Surg. 1980 May;191(5):576–583. doi: 10.1097/00000658-198005000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Adson M. A., van Heerden J. A., Adson M. H., Wagner J. S., Ilstrup D. M. Resection of hepatic metastases from colorectal cancer. Arch Surg. 1984 Jun;119(6):647–651. doi: 10.1001/archsurg.1984.01390180015003. [DOI] [PubMed] [Google Scholar]
  3. FISHER E. R., FISHER B. EXPERIMENTAL STUDIES OF FACTORS INFLUENCING THE DEVELOPMENT OF HEPATIC METASTASES. XIII. EFFECT OF HEPATIC TRAUMA IN PARABIOTIC PAIRS. Cancer Res. 1963 Jul;23:896–900. [PubMed] [Google Scholar]
  4. Fortner J. G., Kim D. K., Maclean B. J., Barrett M. K., Iwatsuki S., Turnbull A. D., Howland W. S., Beattie E. J., Jr Major hepatic resection for neoplasia: personal experience in 108 patients. Ann Surg. 1978 Sep;188(3):363–371. doi: 10.1097/00000658-197809000-00011. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Fortner J. G., Silva J. S., Golbey R. B., Cox E. B., Maclean B. J. Multivariate analysis of a personal series of 247 consecutive patients with liver metastases from colorectal cancer. I. Treatment by hepatic resection. Ann Surg. 1984 Mar;199(3):306–316. doi: 10.1097/00000658-198403000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Foster J. H. Survival after liver resection for secondary tumors. Am J Surg. 1978 Mar;135(3):389–394. doi: 10.1016/0002-9610(78)90072-7. [DOI] [PubMed] [Google Scholar]
  7. GILBERTSEN V. A., WANGENSTEEN O. H. A summary of thirteen years' experience with the second look program. Surg Gynecol Obstet. 1962 Apr;114:438–442. [PubMed] [Google Scholar]
  8. Goslin R., Steele G., Jr, Zamcheck N., Mayer R., MacIntyre J. Factors influencing survival in patients with hepatic metastases from adenocarcinoma of the colon or rectum. Dis Colon Rectum. 1982 Nov-Dec;25(8):749–754. doi: 10.1007/BF02553304. [DOI] [PubMed] [Google Scholar]
  9. Iwatsuki S., Shaw B. W., Jr, Starzl T. E. Experience with 150 liver resections. Ann Surg. 1983 Mar;197(3):247–253. doi: 10.1097/00000658-198303000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Kortz W. J., Meyers W. C., Hanks J. B., Schirmer B. D., Jones R. S. Hepatic resection for metastatic cancer. Ann Surg. 1984 Feb;199(2):182–186. doi: 10.1097/00000658-198402000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Logan S. E., Meier S. J., Ramming K. P., Morton D. L., Longmire W. P., Jr Hepatic resection of metastatic colorectal carcinoma: a ten-year experience. Arch Surg. 1982 Jan;117(1):25–28. doi: 10.1001/archsurg.1982.01380250015003. [DOI] [PubMed] [Google Scholar]
  12. Nielsen J., Balslev I., Jensen H. E. Carcinoma of the colon with liver metastases. Operative indications and prognosis. Acta Chir Scand. 1971;137(5):463–465. [PubMed] [Google Scholar]
  13. Rajpal S., Dasmahapatra K. S., Ledesma E. J., Mittelman A. Extensive resections of isolated metastasis from carcinoma of the colon and rectum. Surg Gynecol Obstet. 1982 Dec;155(6):813–816. [PubMed] [Google Scholar]
  14. Steele G., Jr, Zamcheck N., Wilson R., Mayer R., Lokich J., Rau P., Maltz J. Results of CEA-initiated second-look surgery for recurrent colorectal cancer. Am J Surg. 1980 Apr;139(4):544–548. doi: 10.1016/0002-9610(80)90335-9. [DOI] [PubMed] [Google Scholar]
  15. Tartter P. I., Slater G., Gelernt I., Aufses A. H., Jr Screening for liver metastases from colorectal cancer with carcinoembryonic antigen and alkaline phosphatase. Ann Surg. 1981 Mar;193(3):357–360. doi: 10.1097/00000658-198103000-00019. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Wanebo H. J., Semoglou C., Attiyeh F., Stearns M. J., Jr Surgical management of patients with primary operable colorectal cancer and synchronous liver metastases. Am J Surg. 1978 Jan;135(1):81–85. doi: 10.1016/0002-9610(78)90014-4. [DOI] [PubMed] [Google Scholar]
  17. Wilkins E. W., Jr, Head J. M., Burke J. F. Pulmonary resection for metastatic neoplasms in the lung. Experience at the Massachusetts General Hospital. Am J Surg. 1978 Apr;135(4):480–483. doi: 10.1016/0002-9610(78)90023-5. [DOI] [PubMed] [Google Scholar]
  18. Wilson S. M., Adson M. A. Surgical treatment of hepatic metastases from colorectal cancers. Arch Surg. 1976 Apr;111(4):330–334. doi: 10.1001/archsurg.1976.01360220026004. [DOI] [PubMed] [Google Scholar]
  19. Wood C. B., Gillis C. R., Blumgart L. H. A retrospective study of the natural history of patients with liver metastases from colorectal cancer. Clin Oncol. 1976 Sep;2(3):285–288. [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES