Hepatic resection for colorectal metastases--selection of cases and determinants of success.

Twenty-six patients undergoing hepatic resection for colorectal metastases have been followed for periods varying from 1 month to 8 years. The actuarial 5 year survival rate was just over 50% for all patients. Patients surviving for more than 2 years have been considered separately, and an attempt was made to determine what clinical factors determine whether a patient is likely to benefit from surgery or not. A stage I hepatic lesion, involvement of one rather than both lobes, the presence of less than four metastases and pathological proof that resection margins were free of tumour combined to define a group of patients with a 75% 5 year survival rate. The stage of the disease and the presence of unilobar metastases were the most important determinants of benefit. Patients demonstrating one or more unfavourable factors did not appear to benefit from hepatic resection.