Hepatic resections for colorectal metastases in The Netherlands. A multiinstitutional 10-year study.
METHODS
The records of 118 patients who had hepatic resections for colorectal liver metastases were analyzed retrospectively.


RESULTS
The patient group, from 15 institutions in The Netherlands, was found to have a 5-year actuarial survival rate of 21% and a 5-year actuarial disease-free survival rate of 19%. The postoperative mortality rate was 7.6%. In the remaining group, the morbidity rate was 34.7%. A number of factors were examined that were reported to be of prospective significance in other studies. In the multivariate proportional hazard model of Cox, the number of metastases (P = 0.001) and the amount of perioperative blood loss (P = 0.002) were related significantly to disease-free survival. A factor that may be considered a contraindication to resection is the presence of extrahepatic disease (whether nodal or visceral), even if resectable.


CONCLUSIONS
Although the actual benefit of resection is limited, and it is associated with considerable morbidity, surgical therapy offers some patients a chance for cure. It is a valid expectation that improvement in techniques and a proper understanding of hepatic anatomy will improve the safety and efficacy of hepatic resections in the future. Future research should focus on defining better selection criteria and on study of the value of adjuvant treatment modalities.
van Ooijen
B
B
Department of Surgical Oncology and Statistics, Dr. Daniel den Hoed Cancer Center, Rotterdam, The Netherlands.
Wiggers
T
T
Meijer
S
S
van der Heijde
M N
MN
Slooff
M J
MJ
van de Velde
C J
CJ
Obertop
H
H
Gouma
D J
DJ
Bruggink
E D
ED
Lange
J F
JF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008099:Liver / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000009:adverse effects