title: [Reflections on 250 interventions for colorectal carcinoma metastases to the liver].
abstract: BACKGROUND
  The best results in the treatment of colorectal cancer metastases to the liver are currently achieved with surgical resection performed under high quality standards. OBJECTIVES. To analyze the results and quality standards of the surgical treatment of colorectal cancer liver metastases in a referral liver unit over an 11-year period.
  
  
  METHODS
  From January 1995 to December 2005, 250 surgical interventions were performed in 221 patients diagnosed with colorectal cancer liver metastases, resulting in 201 hepatic resections.
  
  
  RESULTS
  Nineteen percent of patients were >/= 70 years old and comorbidity was present in 54%. Of the 201 hepatic resections, 8.5% were second resections. Major hepatectomy was performed in 39% of the patients. R0 resection was achieved in 85% of the patients. Blood transfusions were not required in 80% of the patients. The median length of postoperative stay was 6 days. Postoperative mortality was nil and morbidity was 19%. Morbidity was associated with the number of resected segments and the need for blood transfusion. The estimated 1-, 3- and 5-year cumulative survival rates were 96%, 69% and 52%, respectively, while estimated disease-free survival rates were 58%, 32% and 24%, respectively.
  
  
  CONCLUSIONS
  Resection of colorectal cancer liver metastases is an effective therapeutic alternative if high current quality standards are achieved.
authors.affiliation: Unidad de Cirugía y Trasplante Hepatobiliopancreático, Hospital Universitario La Fe, Valencia, España. rlopezandujar@telefonica.net
authors.forename: Rafael López
authors.initials: RL
authors.lastname: Andújar
authors.forename: Eva Montalvá
authors.initials: EM
authors.lastname: Orón
authors.forename: Angel Moya
authors.initials: AM
authors.lastname: Herraiz
authors.forename: Carlos Redondo
authors.initials: CR
authors.lastname: Cano
authors.forename: Fernando San Juan
authors.initials: FS
authors.lastname: Rodríguez
authors.forename: Eugenia Pareja
authors.initials: EP
authors.lastname: Ibars
authors.forename: Manuel De Juan
authors.initials: Mde J
authors.lastname: Burgueño
authors.forename: Francisco Orbis
authors.initials: FO
authors.lastname: Castellanos
authors.forename: José Mir
authors.initials: JM
authors.lastname: Pallardó
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy / Q000706:statistics & numerical data; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged