[11 years of experience in the surgical therapy of the liver metastases from colorectal tumors].
Surgery represents the only therapeutic remedy for liver metastases from colo-rectal cancer where satisfactory long term survivals have been reported. We have retrospectively analyzed the 11 year experience in the resective treatment of 108 patients operated on at our Surgery Department. Fourteen wedge resections, 52 segmentectomies and 42 major hepatectomies have been carried out. The operative mortality rate has been 0.9%. The post-operative course was uneventful in 86 (79.6%) cases, while 19 (17.6%) had one complication, 2 (1.9%) had two and only one had three. Overall, 62 (57.4%) patients are alive and 46 (42.6%) have died. The actuarial survival rate has been 45.7% and 28% at 3 and at 5 years respectively. The pre-operative CEA value, the percentage of the tumoral parenchymal involvement and the year of the operation tabulated independently produced better results using Cox's multivariate analysis. On the basis of these variables, it has been possible to identify a group of 49 patients with a 3 and 5 year actuarial survival of 70.3%. The use of intra-operative echography is essential in this surgery, guiding anatomical resection without the need for blood transfusions. Liver resection must be considered for patients with single or multiple liver metastases that are surgically treatable.
Istituto di Clinica Chirurgica II, Policlinico Sant'Orsola, Università di Bologna.
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Gozzetti
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Mazziotti
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Grazi
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Jovine
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Frena
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000401:mortality / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis
Undici anni di esperienza nella terapia chirurgica delle metastasi epatiche da tumori colo-rettali.