Features of Synchronous Colorectal Hematogenous Metastasis and Treatment for Liver Metastasis

Yoshihiro Yamazoe, Shunzou Maetani, Toshikuni Nishikawa, Norimichi Kan, Gouhei Satoh, Takayoshi Tobe

The First Department of Surgery, Kyoto University, School of Medicine

We analyzed the data on 171 colorectal cancers with liver metastasis which was confirmed during resection of the primary tumor (136 patients) or during surgery for metachronus metastasis (35). Curative liver resections were performed in 49 patients, and intraarterial adoptive immunotherapy (AIT) in 15. The prognosis was determined mainly by the grade of liver or lung metastsis. For H-3 cases, intraarterial therapy had an unfavorable effect on survival. Of patients receiving hepatectomy those with multiple and small (<4 cm) metastases showed poor survival. AIT appeared effective either for patients with multiple and small metastases or as adjuvant therapy after liver resection. We conclude that we should limit intraarterial therapy to selected cases, considering the costbenefit balance and quality of life. A prospective study is needed to confirm the effectiveness of adjuvant intraarterial therapy and to evaluate its comparative effects for different grades of metastasis.

Key words
synchronous colorectal hematogeneous metastasis, liver resection, adoptive immunotherapy

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Yoshihiro Yamazoe First Department of Surgery, Kyoto University, School of Medicine
54 Shogoin-Kawaracho, Sakyoku, Kyoto, 606 JAPAN

Accepted
November 19, 1990

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