Resection of ‘recurrent’ colorectal metastases to the liver

Hepatic resection is the only treatment for patients with colorectal cancer metastatic to the liver that has resulted in long‐term survival. This apparent efficacy of hepatectomy has prompted efforts to expand the surgical approach for disease progression within the liver. A review of personal experience and of the literature was performed in an attempt to define the role of surgery for disease progression. Twenty‐one patients who underwent hepatic resection between 1983 and 1991 for isolated disease progression in the liver were retrospectively reviewed. The median follow‐up of patients still alive was 1.7 years (range 4 months to 4.5 years). The median survival from the date of repeat hepatic resection was 3.4 years with an estimated actuarial survival rate of 43 per cent at 4 years. These patients experienced no significant morbidity and the mortality rate was 5 per cent. Hepatic resection of metastatic colorectal carcinoma can produce long‐term survival without prohibitive risk. These findings support an aggressive surgical approach for metastatic progression in the liver from colorectal carcinoma.