Hepatic resection has been proposed as an effective way to treat metastatic colorectal carcinoma.
Researchers in Italy undertook a study to determine if contemporary resection of intestinal primary tumor and hepatic metastases is effective in the treatment of patients with metastases recognized at the initial clinical presentation of the primary tumor.
The research group carried out a retrospective study to analyze the effect of patient demographics, tumor characteristics, and treatment factors on early and long-term outcome of patients submitted to synchronous intestinal and hepatic resection for colorectal liver metastases.
The investigators included 78 patients who had undergone surgical resection of primary colorectal tumor and hepatic metastases with curative intent between 1988 and 1999.
The researchers set criteria for study recruitment; these included a controllable primary tumor, no detected extrahepatic disease, and negative surgical margins of hepatic resection.
|Number of metastases, resection margin and portal nodal status are independent predictors of adverse long-term outcome|
|International Journal of Colorectal Disease|
Using univariate analysis the researchers were able to show that adverse predictors of the long-term outcome included:
Number of metastases (3; >3),
Pre-operative CEA value >100 ng/ml,
Resection margin <10 mm,
Portal nodal status.
The researchers confirmed, on further multivariate analysis, that the number of metastases, resection margin and portal nodal status were independent predictors.
Dr Adriano Tochi conluded, "Our findings confirm hepatic resection as an effective procedure when undertaking combined bowel and hepatic resection."
"The applicability and the outcome of this surgical strategy is definitively influenced by the chance of a radical resection of the primary tumor, the number of hepatic metastases, resection margin wider than 1 cm, positive portal nodes, and the absence of any extrahepatic metastatic disease."