[Hepatic metastasis of colorectal cancer. Should it be surgically treated? Report of 55 cases].

Surgical resection currently represents the best chance of improving survival for some patients with hepatic metastases (H.M.) of colorectal origin. Out of a total of 288 patients with H.M. from colorectal cancer, 55 only had a surgical exeresis (hepatectomy or removal of the metastasis). These were 36 cases of synchronous H.M. and 19 of metachronous H.M. The operative mortality is as high as 2%. The overall actuarial survival rate at 5 years is 19.6%. The single-factor analysis of the factors connected with survival reveals 2 deciding factors: the margin of normal peritumoral hepatic parenchyma resected (p less than 0.01) and the degree of tumoral differentiation (p less than 0.05). A preoperative CEA level higher than 30 ng/l may be a pejorative factor (p less than 0.05). The results of this series are likely to be improved: 1 degree by a better selection of the patients scheduled for resection, especially as it is necessary to extend resection into the normal parenchyma more than 1 cm from the tumor, and 2 degrees by the addition of an adjunctive regional chemotherapy.