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Surgical resection of metastatic cancer to the liver

Operative Therapie von Lebermetastasen

  • Themenschwerpunkt: Chirurgische Therapie von Metastasen
  • Published:
Acta Chirurgica Austriaca Aims and scope Submit manuscript

Summary

Background

Surgical resection is the only treatment modality that provides the chance of cure for patients with metastatic spread to the liver.

Methods

This report reviews the indication, technique and results of surgical resection of liver metastases.

Results

Most of the data on hepatic resection for metastatic disease relates to colorectal secondaries. Generally 5-year survival rates between 30 and 40% have been reported after surgical treatment of liver metastases originating from colorectal cancer. The operative mortality ranges between 0 and 5%. However these positive results are only obtained in patients with less than 4 metastases and without extrahepatic spread. Consequently careful preoperative staging is mandatory to identify patients who are likely to benefit of operative treatment. The criteria for the indication for liver resection of non-colorectal liver metastases have not yet been defined clearly. For such tumors the prognosis after liver resection is significantly poorer compared to patients with colorectal malignancy.

Conclusions

Surgical resection of liver metastases from colorectal cancer can improve the prognosis in selected patients and even result in cure. In contrast liver resection in patients with non-colorectal primaries rarely results in improved prognosis.

Zusammenfassung

Grundlagen

Die chirurgische Resektion von Lebermetastasen ist weiterhin die einzige Therapiemodalität, die eine kurative Therapie von Lebermetastasen ermöglicht.

Methodik

In dieser Arbeit stellen wir die Indikationen, Technik und Ergebnisse der operativen Therapie von Lebermetastasen anhand der eigenen Erfahrungen und Bewertung der Literatur dar.

Ergebnisse

Die meisten Daten bezüglich der Resektion von Lebermetastasen liegen von den kolorektalen Karzinomen vor. Hier können bei sorgfältiger Indikationsstellung 5-Jahres-Überlebensraten von 30% erzielt werden. Die operative Mortalität liegt unter 5%. Diese positiven Ergebnisse können jedoch nur erzielt werden, wenn weniger als 4 Metastasen vorhanden sind und keine extrahepatische Manifestation vorliegt. Daher ist ein sorgfältiges präoperatives Staging zur Abklärung der Resektabilität und Kurabilität obligat. Die Kriterien für die Indikation zur Leberresektion von Metastasen nichtkolorektaler Karzinome sind noch nicht ausreichend festgelegt. Die 5-Jahres-Überlebensrate nach Resektion von Lebermetastasen nichtkolorektaler Karzinome ist im allgemeinen geringer als die kolorektaler Karzinome.

Schlußfolgerungen

Die Resektion von Lebermetastasen führt bei definierten Patienten-Subgruppen mit kolorektalem Karzinom zu einer verbesserten Prognose und teilweise zur Heilung der Erkrankung. Bei Metastasen nichtkolorektaler Primärtumoren ist nur in Ausnahmefällen eine solche Prognoseverbesserung zu erzielen.

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Authors and Affiliations

  1. Department of Surgery and Surgical Oncology, Virchow Hospital, Humboldt University, Robert-Rössle Hospital and Tumor Institute, Rössle-Klinik, Lindenberger Weg 80, D-13122, Berlin, Germany

    P. M. Schlag M.D., M. Hünerbein & P. Hohenberger

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Schlag, P.M., Hünerbein, M. & Hohenberger, P. Surgical resection of metastatic cancer to the liver. Acta Chir Austriaca 28, 27–32 (1996). https://doi.org/10.1007/BF02625952

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