The result of liver resection for colorectal metastases in a small volume hospital in western Norway.
OBJECTIVE
Our aim was to compare liver resection for colorectal metastases in a non-referral, small volume unit with a dedicated staff, with results from larger units.


METHODS
Thirty patients (15 men and 15 women) with a median age of 64years (range 29-78) underwent hepatic resection during a 5-year period from 1997 to 2003 in a teaching hospital in western Norway.


RESULTS
Sixty-three percent (19/30) of the colorectal tumours were Dukes stage C (n=19) and CEA was increased in seven patients (23%), of which four (13%) had values above 50microg/l. The metastases were synchronous with the colorectal tumours in 11 patients (37%). Non-anatomical (wedge) resections were the dominant type of surgeries and the resection margins were clear in all patients. A 77-year-old man (3%) died of MOF after right hemihepatectomy. Morbidity was encountered in eight other patients (28%). In 22 patients (76%) with recurrent disease, metastases first appeared in the liver in 18 (82%) of these patients. Seven patients (23%) have had resections for recurrences. Mean time to recurrence was 20months (range 3-87). The actuarial 5-year survival rate was 42%. Six patients (20%) are currently disease free.


CONCLUSIONS
Although our unit has treated a small number of patients compared with specialized units elsewhere, the survival rate, as well as morbidity and mortality, were comparable. However, 62% have had recurrent liver disease and this may suggest a role for neoadjuvant or adjuvant chemotherapy in selected cases.
Søndenaa
K
K
Institute of Surgical Sciences, University of Bergen, Norway. kasoende@online.no
Nesvik
I
I
Eiriksson
K
K
Vetrhus
M
M
D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009664:Norway