Liver resection in metastatic colorectal cancer: a multidisciplinary approach.

ABSTRACT

AIM: To analyze qualitative short-time results of a new program for multidisciplinary liver evaluation in complex cases of liver metastasis from colorectal cancer. PATIENTS AND METHODS: 40 clinical consecutive evaluations with liver metastasis assessed for major liver resection by a multidisciplinary specialist committee. Complementary explorations performed included CT and ultrasounds, and MRI or PET for doubtful cases. Liver resection was made in a single operation or two-stage hepatectomy, or combined with other techniques. RESULTS: Postoperative mortality at 30 days was 4%. Complications occurred in 28%, with surgical wound infection being most frequent (20%); 16.6% of resections were transfused, with a mean volume of 1000 ml. Two patients needed reoperation -one for an intraperitoneal abscess and one for bile-duct stenosis. Percentage of global relapse was 36%, with 26% of relapses out of the liver. Actuarial survival at one year follow-up was 90%, and 82% at two years; 64% of patients remain free of disease two years after the operation. CONCLUSIONS: Programs for liver resection for colorectal cancer metastasis may be implemented by multidisciplinary teams of recent setup. There is a need to evaluate own results and then compare them with a standard of quality previously reported.