Resultados del tratamiento quirúrgico de las metástasis hepáticas por cáncer colorrectal

Resumen

Background: Surgical resection is the only treatment associated
with long-term cure in patients with liver metastasis from colorectal cancer, achieving a 30% to
40% five years survival. Aim: To evaluate the results of liver resection for metastatic colorectal
cancer in our centre. Patients and methods: Retrospective study. Epidemiological,
perioperative and follow up data of patients undergoing liver resection for metastatic colorectal
cancer between January 1990 and July 2007 were assessed. We compared the results between
two periods; period 1 (1990-1997) and period 2 (1998-2007). Results: Sixty six patients aged
61±12 years (46 males) underwent 75 resections. An anatomical excision was performed in 54
(72%) cases, a right hepatectomy in 18, an extended right hepatectomy in 11, a left
hepatectomy in 1, and a segmentectomy in 24. In 24 (32%) patients the liver resection was
simultaneous with the colorectal cancer resection. Operative time was 221±86 min. Hospital
stay was 11±5 days. Postoperative morbidity was 35% and surgical mortality was 0%. Resection
margin was free of tumor in 53 (80%) patients. Five years overall and hepatic disease-free
survival was 38% and 23%, respectively. In period 2, more anatomical resections than in period
1 were performed (77% and 55%, respectively, p =0.04), without an increase in complications
(35% and 34%, respectively; p =ns), but with a better five years survival (45% and 21%,
respectively, p =0.04). Conclusions: Five years survival for excision of liver metastatic
colorectal cancer in our center is similar to that reported abroad. During the second period
there has been a trend toward more extensive resections which was associated with a better
survival, without an increase in complications or mortality.