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[Surgical resection of hepatic metastases of cancers of the colon and rectum].

Surgical resection of metastatic colorectal carcinoma remains controversial. Few patients are eligible for resection since out of 2,725 patients operated upon for colonic or rectal adenocarcinomas in 11 years, 14 p. 100 had liver metastases and only 0.9 p. 100 could be resected. Twenty-nine patients who have undergone partial liver resections for metastatic colorectal carcinomas are reported. The primary neoplasms were Duke's class B(8), Dukes' C (12) or extended to another organ (5). Local extension was unknown in 4 cases. Eight metastases were unique and measured less than 5 cm; seven, although unique, measured more than 5 cm. Fourteen patients had multiple but unilateral hepatic deposits. Twenty major resections and 9 wedge liver resections were performed. One patient died (3.4 p. 100). Average hospital stay was 19 days. Pain was relieved by surgery in 10/11 patients. In 19 patients follow-up exceeds one year: six underwent the resection of a unique and small liver metastasis: one died after 3 and a half years and two are doing well 4 and 10 years after surgery. Thirteen patients underwent major liver resections for large or multiple liver deposits: 9 lived less than one year and 4 are alive after 16, 19, 26 and 60 months respectively. All patients with a follow-up of less than one year are alive. The low operative mortality, the efficacy in relieving pain, and the prolonged survival which can be obtained in some cases justify an aggressive surgical approach to colorectal liver metastases.