Хирургическое лечение метастазов колоректального рака в печень

Aim. To improve the outcomes in patients with colorectal cancer liver metastases. Material and Methods. 326 patients with colorectal cancer liver metastases were enrolled. In 185 cases liver resection was  performed including advanced resection in 73 patients and minor  procedures in 112 cases. Radiofrequency ablation of metastases was performed in 141 patients: open in 7 cases, transdermal – in 134 patients. Results . The most frequent complications after liver resection were hepatic insufficiency (8.6%), hematoma (abscess) within liver stump (4.9%), pleuritis (4.9%), subdiaphragmatic abscess (3.8%).  Mortality after advanced liver resection was 1.6%. 1-year survival  after liver resection was 74.8%, 3-year survival – 46.7%, 5-year  survival – 26.7%. Complications after radiofrequency ablation were  detected in 11 (7.8%) observations: pleuritic in 7, hematoma within  puncture channel in 3, liver abscess – in 1 case. Overall 1-year  survival was 88.2 ± 7.9%, 2-year – 68.0 ± 14.1%, 3-year – 30.5 ± 13.2%. Conclusion. Surgical treatment of colorectal cancer liver metastases remains the main radical method to achieve satisfactory results.  Radiofrequency ablation is effective for colorectal cancer liver  metastases and may be applied repeatedly. Maximum effectiveness  of ablation is noted for destruction of metastases up to 3 cm.  Radiofrequency ablation may be used as an independent method of  treatment, however combined treatment is preferred in patients with colorectal cancer metastases.