Download Introduction: Liver metastases are the most common cause of death

Introduction: Liver metastases are the most common cause of death in colorectal cancer patients.
complete resection is considered to be the only curative treatment. Different interventional techniques
have been developed in recent years for the treatment of secondary liver metastases because less than
30% of patients are suitable candidates for surgery.
Material and method: This is a prospective study including patients with liver metastases of colorectal
cancer hospitalized in Ist and IInd Clinics of Surgery during 2003-2016
Results: There were submitted 1099 patients with liver metastases of colorectal cancer, in 35% of the
cases the lesions were synchronous and 65% of the patients had metachronous metastases. Only 31%
of patients have benefited from a curative resection and 25% of the surgical procedures were R0
resection. The treatment strategies for metachronous liver metastases were resection at the time of
discovery or focal destruction for unresectable lesions. In case on synchronous liver metastases the
treatment consisted in simultaneous approach of the primary tumor and metastatic lesion (liver
resection or focal destruction) if the tumor extension and the patient biological status allowed. In
patients with resection of the liver metastases the 5-year survival was 32% and in case of unresectable
lesions the survival was between 7.5 and 12 month.
Conclusion: Hepatic resection is the optimal treatment for colorectal liver metastases. Anatomic or
atypical surgical resection are both indicated if R0 is obtained. Modern strategies such as ligation /
embolization portal, chemoembolisation or focal destruction techniques are indicated both in
association with hepatic resection and as single therapeutic method "rescue".
Bibiography
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