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Modern surgery for liver metastases.

Lodge JP - Cancer Imaging (2000)

View Article: PubMed Central - PubMed

Affiliation: Consultant in Hepatobiliary and Transplant Surgery, Hepatobiliary Unit, St James Hospital, Leeds, UK.

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Patients with hepatic metastases from colorectal cancer have a poor prognosis, with a median survival of less than 12 months... Although chemotherapy may have a beneficial effect on the natural history of unresected liver metastases, 5-year survival is difficult to achieve by chemotherapy alone... This author’s practices in surgery for hepatic metastases from colorectal cancer have been more radical than most other surgeons... A careful follow-up protocol with the use of adjuvant chemotherapy and redo resection have enabled this author to achieve satisfactory results (Figs 1 and 2)... In addition, metastases from tumours other than colorectal cancer are also regularly undergoing liver resection... MRI is the imaging method of choice for the liver in our centre, although other groups routinely use CT arterioportography with similar results... About 30% of patients who develop recurrent metastatic disease following hepatic resection will have isolated liver metastases... This is a very worthwhile group to consider for further surgery and results are at least as good as with first-time surgery... Future efforts must concentrate on earlier referral and more rapid assessment for liver surgery... Often the window of opportunity for surgery is narrow and unnecessary delays make surgery difficult or impossible... Surgical techniques continue to advance and there are several new technologies that are becoming incorporated into hepatic resection... Improvements in pre-operative staging and better follow-up radiology are required... The use of adjuvant chemotherapies and ablative therapies may also improve results.

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48% 5-year survival from hepatic resection (n=161).
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Fig1: 48% 5-year survival from hepatic resection (n=161).

Mentions: Patients with hepatic metastases from colorectal cancer have a poor prognosis, with a median survival of less than 12 months. Although chemotherapy may have a beneficial effect on the natural history of unresected liver metastases, 5-year survival is difficult to achieve by chemotherapy alone. Hepatic resection can achieve prolonged survival with an acceptable mortality risk in selected patients, but this approach has classically been reserved for a very select group of patients, usually those with a solitary metastasis discovered some time after the primary colorectal resection. This author’s practices in surgery for hepatic metastases from colorectal cancer have been more radical than most other surgeons[1]. A careful follow-up protocol with the use of adjuvant chemotherapy and redo resection have enabled this author to achieve satisfactory results (Figs 1 and 2).


Modern surgery for liver metastases.

Lodge JP - Cancer Imaging (2000)

48% 5-year survival from hepatic resection (n=161).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4554705&req=5

Fig1: 48% 5-year survival from hepatic resection (n=161).
Mentions: Patients with hepatic metastases from colorectal cancer have a poor prognosis, with a median survival of less than 12 months. Although chemotherapy may have a beneficial effect on the natural history of unresected liver metastases, 5-year survival is difficult to achieve by chemotherapy alone. Hepatic resection can achieve prolonged survival with an acceptable mortality risk in selected patients, but this approach has classically been reserved for a very select group of patients, usually those with a solitary metastasis discovered some time after the primary colorectal resection. This author’s practices in surgery for hepatic metastases from colorectal cancer have been more radical than most other surgeons[1]. A careful follow-up protocol with the use of adjuvant chemotherapy and redo resection have enabled this author to achieve satisfactory results (Figs 1 and 2).

View Article: PubMed Central - PubMed

Affiliation: Consultant in Hepatobiliary and Transplant Surgery, Hepatobiliary Unit, St James Hospital, Leeds, UK.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Patients with hepatic metastases from colorectal cancer have a poor prognosis, with a median survival of less than 12 months... Although chemotherapy may have a beneficial effect on the natural history of unresected liver metastases, 5-year survival is difficult to achieve by chemotherapy alone... This author’s practices in surgery for hepatic metastases from colorectal cancer have been more radical than most other surgeons... A careful follow-up protocol with the use of adjuvant chemotherapy and redo resection have enabled this author to achieve satisfactory results (Figs 1 and 2)... In addition, metastases from tumours other than colorectal cancer are also regularly undergoing liver resection... MRI is the imaging method of choice for the liver in our centre, although other groups routinely use CT arterioportography with similar results... About 30% of patients who develop recurrent metastatic disease following hepatic resection will have isolated liver metastases... This is a very worthwhile group to consider for further surgery and results are at least as good as with first-time surgery... Future efforts must concentrate on earlier referral and more rapid assessment for liver surgery... Often the window of opportunity for surgery is narrow and unnecessary delays make surgery difficult or impossible... Surgical techniques continue to advance and there are several new technologies that are becoming incorporated into hepatic resection... Improvements in pre-operative staging and better follow-up radiology are required... The use of adjuvant chemotherapies and ablative therapies may also improve results.

No MeSH data available.