To evaluate the therapeutic results and determine the prognostic factors, 42 patients who underwent hepatic resection for metastatic colorectal cancers between January 1980 to December 1994 at the Department of Surgery, Seoul National University
Hospital, were analyzed. Thirty seven patients(88.1%) had metastasis confined to one lobe and five patients(11.9%) had metastasis involving both lobes. Twenty four patients(57.2%) had solitary metastases, while eighteen patients(42.8%) had 2 or
more
metastases. Mean size of the metastatic lesions was 2.5cm. Of 42 patients, 2(54.8%) had synchronous metastases and 19 (45.2%) had metachronous metastases 4 months to 73 months after the initial operation. Twenty seven patients (64.3%) had Dukes'
C
primary tumor. Twenty Three patients(54.8%) had their original tumor located in rectum followed by sigmoid colon in 8(1.90%), and ascending colon in 7(16.7%). Pathologically, sixteen patients(38.1%) had well-differentiated adenocarcinoma, and
21(50%)
had moderately differentiated adenocarcinoma. Wedge resection was performed in 16 patients(38.1%) followed by lobectomy in 11(26.2%), segmentectomy in 8(19.0%), and subsegmentectomy in 7 patients (16.7%). Minor postoperative complications
occurred
in 12
patients(28.5%), but there was no operative mortality. The median survival of these patients were 41 months and the cumulative 5 year survival rate was 45.2%. Location of the primary tumor(p=0.067), and whether the patients had metastasis
involving
only
one lobe or both lobes of the liver(p0.063) marginally influenced the survival. Factors which were related significantly to survival was the number of metastatic nodules(p=0.028). Size of metastatic nodules, cell types of the primary tumor,
preoperative
serum CEA values, age, sex and whether the patients had synchronous or metachronous metastasis, did not influence the survival. Our data suggest that hepatic resection for metastatic colorectal cancer is a relatively safe procedure with survival
benefit
to patients.
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