PATTERN OF RECURRENCE AFTER HEPATIC RESECTION FOR COLORECTAL METASTASES

Between 1978 and 1989, 159 patients with liver metastases from colorectal cancer underwent hepatic resection. Of 134 patients in whom metastases were confined to the liver, 109 had tumours removed completely with histologically negative resection margins. Two patients died in hospital. Ultrasonographically guided partial resection was performed in 80 patients, lateral segmentectomy in seven and lobectomy in 22. The 5-year survival rate of patients undergoing potentially curative resection was 47.9 per cent. Patients with metachronous tumours showed a significantly better prognosis than those with synchronous lesions in both univariate (P < 0.01) and multivariate (P = 0.01) analysis. During a median follow-up of 35.4 months, 64 patients developed recurrence, including 34 in the liver, 20 in the lung and 12 in the abdominal cavity. Of those with hepatic recurrence, ten patients developed tumours at the initial resection bed, seven in the same lobe, five in the contralateral lobe and 12 in both lobes. Ultrasonographically guided partial liver resection did not increase the risk of hepatic recurrence.