Hepatectomy and postoperative hepatic arterial infusion for liver metastasis from colorectal cancer -analysis of prognostic factors-

The clinical prognostic factors were analyzed in 47 patients who had undergone hepatic resection for liver metastases from colorectal cancers in order to determine the indication and procedure of hepatectomy and the usefulness of postoperative hepatic arterial infusion chemotherapy. A positive resection margin significantly shortened the disease-free survival (p<0.05), whereas a tumor size of less than 3 cm and curative hepatecomy improved overall survival (p<0.01, p<0.05, respectively). No other factors including synchronism, serum carcinoembryonic antigen level, distribution and number of liver tumors, operative method, blood transfusion and hepatic arterial infusion, influenced the survival. When the patients were limited to those with tumors greater than 3 cm in size, hepatic artery infusion chemotherapy significantly lowered the recurrence rate and prolonged the overall survival (p<0.05). We conclude that colorectal liver metastases, even when multiple or bilateral, are indications for hepatectomy as far as their absolute removal could be obtained. Postoperative arterial chemotherapy is strongly recommended for those with tumors larger than 3 cm.