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Hepatic Resection for Metastases From Colorectal Carcinoma Is of Dubious Value

Hepatic Resection for Metastases From Colorectal Carcinoma Is of Dubious Value Abstract In the United States, during the past 5 to 10 years, there has been an increasingly aggressive surgical approach to resection of hepatic metastases from colorectal cancer. Operations for this purpose are currently the most common hepatic operation performed in this country, and the procedure is likely to become even more prevalent. It has been estimated that only about 1000 of the 6000 to 12 000 patients who might be potential candidates yearly actually have a resection.1 While several series have reported 5-year survival rates of about 25% for those who undergo resection of hepatic metastases, comparison of this kind of outcome has been made only with retrospective series, a nonvalid control. Thus, it is not known whether surgical excision of these metastatic lesions is appropriate. A presentation and critical analysis of available data are made in this article in an attempt to provide some kind of rational approach to References 1. Hughes K. Registry of hepatic metastases, resection of the liver for colorectal carcinoma metastases: a multi-institutional study of indications for resection . Surgery . 1988;103:278-288. 2. Adson MA. Resection of liver metastases: when is it worthwhile? World J Surg . 1987;11:511-520.Crossref 3. Findlay IG, Meek D, Brunton F, McCardle CS. Growth rate of hepatic metastases in colorectal carcinoma . Br J Surg . 1988;75:641-644.Crossref 4. Oxley EM, Ellis H. Prognosis of carcinoma of the large bowel in the presence of liver metastases . Br J Surg . 1969;56:149-152.Crossref 5. Baden H, Anderson B. Survival of patients with untreated liver metastases from colorectal cancer . Scand J Gastroenterol . 1975;10:221-223. 6. Wood CB, Gillis CR, Blumgart LH. A retrospective study of the natural history of patients with liver metastases from colorectal cancer . J Clin Oncol . 1976;2:285-288. 7. Bengtsson G, Carlsson G, Hafstrom L, Johnson P. Natural history of patients with untreated liver metastases from colorectal cancer . Am J Surg . 1981;141:586-589.Crossref 8. Boey J, Choi TK, Wong J, Ong GB. Carcinoma of the colon and rectum with liver involvement . Surg Gynecol Obstet . 1981;153:864-868. 9. Goslin R, Steele G, Zamcheck N, Mayer T, MacIntyre J. Factors influencing survival in patients with hepatic metastases from adenocarcinoma of the colon and rectum . Dis Colon Rectum . 1982;25:749-754.Crossref 10. Lahr CJ, Scong S-J, Cloud G, Smith JW, Urish MM, Balch CM. A multifactorial analysis of prognostic factors in patients with liver metastases from colorectal carcinoma . J Clin Oncol . 1983;1:720-726. 11. Finan PH, Marshall, RJ, Cooper EH, Giles CR. Factors affecting survival in patients with synchronous hepatic metastases from colorectal cancer: a clinical and computer analysis . Br J Surg . 1985;72:373-377.Crossref 12. Wagner JS, Adson MA, van Heerden JA, Adson MH, Ilstrup DW. The natural history of hepatic metastases from colorectal cancer . Ann Surg . 1984;199:502-508.Crossref 13. Morris MJ, Newland RC, Philes MT, Macpherson JG. Hepatic metastases from colorectal carcinoma: an analysis of survival rates and histopathology . Aust NZ J Surg . 1977;47:365-368.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Hepatic Resection for Metastases From Colorectal Carcinoma Is of Dubious Value

Silen, William
Archives of Surgery , Volume 124 (9) – Sep 1, 1989
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References (16)

Publisher
American Medical Association
Copyright
Copyright © 1989 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1989.01410090027004
Publisher site
See Article on Publisher Site

Abstract

Abstract In the United States, during the past 5 to 10 years, there has been an increasingly aggressive surgical approach to resection of hepatic metastases from colorectal cancer. Operations for this purpose are currently the most common hepatic operation performed in this country, and the procedure is likely to become even more prevalent. It has been estimated that only about 1000 of the 6000 to 12 000 patients who might be potential candidates yearly actually have a resection.1 While several series have reported 5-year survival rates of about 25% for those who undergo resection of hepatic metastases, comparison of this kind of outcome has been made only with retrospective series, a nonvalid control. Thus, it is not known whether surgical excision of these metastatic lesions is appropriate. A presentation and critical analysis of available data are made in this article in an attempt to provide some kind of rational approach to References 1. Hughes K. Registry of hepatic metastases, resection of the liver for colorectal carcinoma metastases: a multi-institutional study of indications for resection . Surgery . 1988;103:278-288. 2. Adson MA. Resection of liver metastases: when is it worthwhile? World J Surg . 1987;11:511-520.Crossref 3. Findlay IG, Meek D, Brunton F, McCardle CS. Growth rate of hepatic metastases in colorectal carcinoma . Br J Surg . 1988;75:641-644.Crossref 4. Oxley EM, Ellis H. Prognosis of carcinoma of the large bowel in the presence of liver metastases . Br J Surg . 1969;56:149-152.Crossref 5. Baden H, Anderson B. Survival of patients with untreated liver metastases from colorectal cancer . Scand J Gastroenterol . 1975;10:221-223. 6. Wood CB, Gillis CR, Blumgart LH. A retrospective study of the natural history of patients with liver metastases from colorectal cancer . J Clin Oncol . 1976;2:285-288. 7. Bengtsson G, Carlsson G, Hafstrom L, Johnson P. Natural history of patients with untreated liver metastases from colorectal cancer . Am J Surg . 1981;141:586-589.Crossref 8. Boey J, Choi TK, Wong J, Ong GB. Carcinoma of the colon and rectum with liver involvement . Surg Gynecol Obstet . 1981;153:864-868. 9. Goslin R, Steele G, Zamcheck N, Mayer T, MacIntyre J. Factors influencing survival in patients with hepatic metastases from adenocarcinoma of the colon and rectum . Dis Colon Rectum . 1982;25:749-754.Crossref 10. Lahr CJ, Scong S-J, Cloud G, Smith JW, Urish MM, Balch CM. A multifactorial analysis of prognostic factors in patients with liver metastases from colorectal carcinoma . J Clin Oncol . 1983;1:720-726. 11. Finan PH, Marshall, RJ, Cooper EH, Giles CR. Factors affecting survival in patients with synchronous hepatic metastases from colorectal cancer: a clinical and computer analysis . Br J Surg . 1985;72:373-377.Crossref 12. Wagner JS, Adson MA, van Heerden JA, Adson MH, Ilstrup DW. The natural history of hepatic metastases from colorectal cancer . Ann Surg . 1984;199:502-508.Crossref 13. Morris MJ, Newland RC, Philes MT, Macpherson JG. Hepatic metastases from colorectal carcinoma: an analysis of survival rates and histopathology . Aust NZ J Surg . 1977;47:365-368.Crossref

Journal

Archives of Surgery – American Medical Association

Published: Sep 1, 1989

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