Surgical treatment of colorectal liver metastases - a single center experience over 20 years

Background: Increased frequency of hepatic resection and advances in oncological therapy dramatically improved the long-term outcome of the patients with colorectal liver metastases. The aim of the study is to present the short and long-term results after surgery in patients with colorectal liver metastases, in a single center, over the last two decades. Method: Between 1995 and 2014, a curative-intent liver resection was performed in 526 patients with liver only metastases and 71 patients with both hepatic and extrahepatic metastases of colorectal origin. Results: In patients with liver only metastases, the 1-, 3and 5-years overall survival rates were 89%, 51.9% and 30%, respectively. The morbidity rates were higher in synchronous liver metastases undergoing simultaneous resection. The mortality and survival rates were similar for simultaneous and staged resections (p>0.05). The morbidity, mortality and survival rates for initially unresectable liver metastases rendered to resectability were similar to those of initially resectable metastases (p>0.05). In patients with hepatic and extrahepatic metastases, the survival rate was significantly lower than in patients presenting liver only metastases (p=0.001). Complete resection of the metastases was associated with significantly longer survivals, compared with a palliative hepatectomy (p=0.039). Conclusion: Liver resection offers the chance of more than 5 years survival to 30% of patients with colorectal cancer liver metastases.