Resectional liver surgery in metastatic liver disease.
OBJECTIVE
To increase resectability rate and decrease intra-hepatic recurrence of metastatic liver disease of patients suffering from secondary liver tumors. Metastatic liver disease remains challenging and life threatening. At the time of diagnosis only 10% of patients are amenable to liver resection and of those 60-70% will develop recurrence in the residual liver 16 to 24 months following liver resection


METHODS
Seventy patients out of a total number of 305 seen between November 1991 and May 1998, underwent combined liver resection followed by adjuvant locoregional targeted immunochemotherapy. Patients were divided in two groups. Group A (n=32) had uni-lobular localization of their disease and group B (n=38) had bi-lobular spread of the disease, but tumor occupied was less than 70% of liver surface. All had hepatic resection followed by adjuvant immuno-chemotherapy.


RESULTS
Group A (n=32) had a 5 year survival of 75% with 8 patients alive more than 6 years and a mean survival for alive and dead patients of 50 months. Group B (n=38) had a mean survival of 40 months with 6 patients alive longer than 5 years.


CONCLUSIONS
Liver resection combined with adjuvant immuno-chemotherapy enhances overall long-term survival in both patients with limited and advanced metastatic liver disease, and is recommended as a promising therapeutical alternative.
Athens Medical Center (Dept. of P. Faliron), Greece.
N J
NJ
Lygidakis
N
N
Spentzouris
G
G
Dedemadi
D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality* / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000401:mortality / Q000517:prevention & control*; D015996:Survival Rate; D014057:Tomography, X-Ray Computed