Liver resection experience in metastatic colorectal cancer patients
Summary. The median survival of colorectal cancer patients with synchronous liver metastases (sM-CRC) without surgical treatment is in the range of 6–12 months, chemotherapy can increase survival of thisit up to 19 months. By this time remains controversial treatment algorithm for these patients, including efficacy of simultaneous resections of the primary tumor and distant synchronous liver metastases. The research is based on the study results of treatment of 125 patients with sM-CRC (pT1–4N0–2M1 — colon cancer and pT1–3N0–2M1 — rectal cancer) who performed simultaneous (group I) or staged (group II) surgery in the period from 2008 to 2015 in clinic of National Cancer Institute. The total level of postoperative complications was 30.6 and 25.0% in groups I and II respectively (p=0.51). Overall 5-year cumulative survival rate of patients with sM-CRC who underwent R0-resection of the primary tumor and synchronous metastases in the liver was 42 and 35% respectively for groups I and II (p=0.73). Median of hypertrophy of future liver remanent in patients with associated liver partition and portal vein ligation (ALP-PVL) was 68%. Resection of liver sM-CRC remains to be the only method that improve long-term outcomes of patients with metastatic CRC, regardless of surgical type treatment. ALP-PVL reduces the risk of acute liver failure in advanced liver resection in patients with CRC and bilobar liver metastatic.
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