title: Surgical treatment for liver metastases from colorectal carcinoma: results of 228 patients.
abstract: OBJECTIVE
  Liver metastases are a very common event. Multiple choices of therapies can be used. The aim of this paper is to analyze results and methods of a single institution series of 228 consecutive patients with colorectal liver metastases.
  
  
  METHODS
  228 consecutive patients underwent hepatic resection for colorectal liver metastases. From different periods intraoperative ultrasound, intraoperative histological examination, locoregional intra-arterial chemotherapy, and radiofrequency thermal ablation were introduced.
  
  
  RESULTS
  Operative mortality was 0.9%. Mean follow-up was 29.5 months. Overall survival was 16% and 9% at 5 and 10 years. 5-year survival was 23% and 6% for patients with single and multiple metastases respectively. For patients with extrahepatic metastatic single lesion 5-year survival was 15%. From the start of intraoperative ultrasound use, 5-year survival was 9% and 27% for patients with multiple and single metastases. Five-year survival for re-resected patients was 13%. Overall survival at 1 and 3 years was 90% and 58% in patients treated with HAI and systemic chemotherapy (disease-free 70% and 47%) and 94% and 12% in patients treated with systemic chemotherapy alone after radical resection (disease-free 53% and 0%).
  
  
  CONCLUSIONS
  Aggressive approach, re-resections, intraoperative ultrasound staging, intra-arterial chemotherapy and radiofrequency thermal ablation are justified in multimodal therapeutic strategy of colorectal metastases and seem to improve patients' survival.
authors.affiliation: Department of Gastroenterological and Surgical Sciences, University of Verona, Italy. n.nicoli@tiscali.it
authors.forename: Nicola
authors.initials: N
authors.lastname: Nicoli
authors.forename: Andrea
authors.initials: A
authors.lastname: Casaril
authors.forename: Gerardo
authors.initials: G
authors.lastname: Mangiante
authors.forename: Michele
authors.initials: M
authors.lastname: Ciola
authors.forename: Moh'd
authors.initials: M
authors.lastname: Abu Hilal
authors.forename: Luigi
authors.initials: L
authors.lastname: Marchiori
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017115:Catheter Ablation / Q000379:methods; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D016019:Survival Analysis