Hepatic resection for colorectal liver metastases: prospective study

CL Liu, ST Fan, CM Lo, WL Law, IOL Ng, J Wong
Centre for the Study of Liver Disease and Department of Surgery, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong

OBJECTIVE. To assess the operative and long-term survival outcomes of hepatic resection for colorectal liver metastases over an 11-year period in a tertiary referral centre in Hong Kong.

DESIGN. Prospective study.

SETTING. University teaching hospital, Hong Kong.

SUBJECTS AND METHODS. Between January 1989 and December 1999, 72 patients underwent hepatic resection for colorectal liver metastases. Clinical, pathological, and outcome data were prospectively collected and analysed. Factors affecting long-term survival were also evaluated.

RESULTS. Twenty-five (34.7%) patients were found to have synchronous hepatic metastasis at the time of colorectal resection, and 52 (72.2%) underwent major hepatic resection. The operative morbidity and hospital mortality rates were 19% and 4%, respectively. The 5-year survival rate after hepatectomy was 31.9%. The median disease-free survival and median overall cumulative survival were 18.5 months and 30.8 months, respectively. On multivariate analysis, a high preoperative serum carcinoembryonic antigen level (>200 ng/mL) and a resection margin involved by tumour on histology were the two independent risk factors that adversely affected survival outcome.

CONCLUSION. Hepatic resection for colorectal liver metastases can be performed safely, with minimal operative mortality and acceptable morbidity, and results in satisfactory survival. High preoperative serum carcinoembryonic antigen level and involvement of resection margin by cancer on histology adversely affect the survival outcome.

Hong Kong Med J 2002;8:329-33

Key words: Colorectal neoplasms; Hepatectomy; Survival analysis