Hepatic Resection for Colorectal Carcinoma Metastases: Present Status and Future Prospects

Summary

In reviewing the literature and in updating the experience at the National Cancer Institute, two conclusions become apparent: 1) liver resection offers the only significant chance of cure in patients with colorectal cancer metastases, and 2) 60–80% of patients who undergo liver resection are not cured. The multifactorial nature of the problem makes it difficult to define specific prognostic groups when dealing with small individual series. Therefore, to encourage future collaborative efforts, a discussion of the staging of hepatic metastases and a protocol matrix for uniform data collection and reporting are proposed. If all data can be synthesized into a central data base, it should be possible to define a group of patients who will benefit from surgery alone, a group who will benefit from surgery plus adjuvant treatments, and a group who will not benefit from surgery. This will allow more knowledgeable patient selection for this major surgical procedure.