Liver resection in metastatic colorectal cancer: a multidisciplinary approach.
OBJECTIVE
To analyze qualitative short-time results of a new program for multidisciplinary liver evaluation in complex cases of liver metastasis from colorectal cancer.


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.
Noguera Aguilar
J F
JF
Unit of Surgery, Hospital Son Llàtzer, Palma, Baleares, Spain. jnoguera@hsll.es
Vicens Arbona
J C
JC
Morales Soriano
R
R
Ibarra de la Rosa
J
J
Arrivi García-Ramos
A
A
Cuadra Coll
M
M
Dolz Abadía
C
C
Pujol Tugores
J J
JJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods* / Q000401:mortality; D006801:Humans; D008099:Liver / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery; D010348:Patient Care Team; D012086:Reoperation; D016019:Survival Analysis