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Liver and pulmonary metastases of the colorectal carcinoma – the experience of the Department of Surgery, University Hospital in Pilsen


Authors: V. Třeška;  J. Vodička;  V. Špidlen;  T. Skalický;  J. Fichtl;  V. Šimánek;  J. Šafránek;  A. Sutnar;  J. Brůha
Authors‘ workplace: Chirurgická klinika FN a LFUK v Plzni, přednosta: Prof. MUDr. V. Třeška, DrSc.
Published in: Rozhl. Chir., 2013, roč. 92, č. 9, s. 488-493.
Category: Original articles

Overview

Introduction:
Liver and pulmonary metastases of the colorectal carcinoma develop in about 20–70%, resp. in 10–22% patients with the colorectal carcinoma. Their treatment is still a matter of discussion. The aim of our study was to evaluate the results of surgical treatment as a part of the multimodal approach.

Material and methods:
30 patients with liver and pulmonary colorectal metastases were operated on between 2002 and 4/2013. The average age was 62.8 ± 10.7 years. 19 patients had metachronous and 11 synchronous metastases. The liver metastases preceded pulmonary in 14 cases, and vice versa in 5 patients. Both types of metastases developed in seven patients simultaneously. Liver resection was performed in 23, radiofrequency ablation (RFA) in 7 patients. Laser pulmonary metastasectomy was performed in 15, pulmonary resection in 14 and RFA in one patient. The liver procedure preceded pulmonary in 25 patients. 73.3% patients had adjuvant oncological treatment.

Results:
30 days mortality rate was 3.3% (N=1) for the actinomycotic sepsis complicated with MRSA infection. Morbidity rate was 10%. Recurrence of liver metastases developed in 6 patients. RFA was performed in all patients. The median of overall and disease free survival was 6.9, resp. 1.1 years.

Conclusion:
Surgical treatment as a part of the multimodal treatment is the only radical treatment for patients with liver and pulmonary metastases. It offers good long-term results.

Key words:
liver and pulmonary metastases of the colorectal carcinoma – surgical treatment


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Surgery Orthopaedics Trauma surgery
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