[Reflections on 250 interventions for colorectal carcinoma metastases to the liver].
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.
Andújar
Rafael López
RL
Unidad de Cirugía y Trasplante Hepatobiliopancreático, Hospital Universitario La Fe, Valencia, España. rlopezandujar@telefonica.net
Orón
Eva Montalvá
EM
Herraiz
Angel Moya
AM
Cano
Carlos Redondo
CR
Rodríguez
Fernando San Juan
FS
Ibars
Eugenia Pareja
EP
Burgueño
Manuel De Juan
Mde J
Castellanos
Francisco Orbis
FO
Pallardó
José Mir
JM
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