Resectional liver surgery in metastatic liver disease

BACKGROUND/AIMS: To increase resectability rate and decrease intra-hepatic recurrence of metastatic liver disease of patients suffering from secondary liver tumors. Metastatic liver disease remains challenging and life threatening. At the time of diagnosis only 10% of patients are amenable to liver resection and of those 60-70% will develop recurrence in the residual liver 16 to 24 months following liver resection. METHODOLOGY: Seventy patients out of a total number of 305 seen between November 1991 and May 1998, underwent combined liver resection followed by adjuvant locoregional targeted immunochemotherapy. Patients were divided in two groups. Group A (n=32) had uni-lobular localization of their disease and group B (n=38) had bi-lobular spread of the disease, but tumor occupied was less than 70% of Liver surface. All had hepatic resection followed by adjuvant immunochemotherapy. RESULTS: Group A (n=32) had a 5 year survival of 75% with 8 patients alive more than 6 years and a mean survival for alive and dead patients of 50 months. Group B (n=38) had a mean survival of 40 months with 6 patients alive longer than 5 years. CONCLUSIONS:Liver resection combined with adjuvant immuno-chemotherapy enhances overall longterm survival in both patients with limited and advanced metastatic liver disease, and is recommended as a promising therapeutical alternative.