Current state of surgical treatment of liver metastases from colorectal cancer

Table 1 Simultaneous vs staged resection of colorectal cancer and synchronous colorectal liver metastases

Author	Patients (n)		Morbidity		Comment
	Sta	Sim	Sta	Sim
Martin et al[73]	160	70	55%	56%	Major hepatectomy rate: Sta 32 % vs Sim 33 %
Slupski et al[74]	61	28	13%	14%	Major hepatectomy rate: Sta 48 % vs Sim 28 %
Moug et al[75]	32	32	59%	34%	Case matched study
Reddy et al[77]	475	135	17.6%	36.1%	Major hepatectomy
			10.5%	14.1%	Minor hepatectomy
de Haas[78]	173	55	25.4%	11%	3-year recurrences: Sta 63.6% vs Sim 85%

Sim: Simultaneous resection; Sta: Staged resection. The lower patient numbers in the simultaneous resection group compared with the staged resection group demonstrate a bias in patient selection. Simultaneous patients often had fewer and smaller metastases and less often underwent major hepatectomy.

Table 2 Survival after repeat liver resection for recurrent colorectal liver metastases

Author	Yr	Patients (n)	5-year survival
Petrowsky et al[87]	2002	126	34%a
Thelen et al[88]	2007	94	38%a
Brachet et al[89]	2009	62	40%b
de Jong et al[91]	2009	246	32.6%c
Mise et al[92]	2010	60	39%d
		21	37%e
		9	20%f

^aFrom time of second liver resection;

^bFrom time of first liver resection;

^cFrom time of second “curative intent surgery” (hepatic resection and RFA included);

^dFrom time of repeated resection for isolated hepatic recurrence;

^eFrom time of repeated resection for isolated pulmonary recurrence;

^fFrom time of repeated resection for hepatic + pulmonary recurrence.

Table 3 Two stage hepatectomy in patients with colorectal liver metastases

Author	Yr	Patients (n)		Survival
		Planned	Feasible
Adam et al[105]	2000	16	13a	35% 3-year OS
Jaeck et al[106]	2004	33	25	54.4% 3-year OS
Togo et al[108]	2005	11	11	45 % 3-year OS
Wicherts et al[109]	2008	59	41	42% 5-year OS
				13% 5-year DFS
Tsai et al[107]	2010	45	35	58% 3-year OS
Karoui et al[110]	2010	33	25b	48% 5-year OS
				22% 5-year DFS

OS: Overall survival; DFS: Disease-free survival.

^aPatients are included in Wicherts et al[109];

^bBilobar synchronous metastases-combined colorectal resection and clearance of one liver lobe as the first stage procedure.