[Evaluation of the number of patients likely to require surgical treatment of hepatic metastases. Based on a series of 180 colorectal cancers].
The spontaneous prognosis of patients with hepatic metastases from colo-rectal cancer is poor in the short term: less than 10 p. cent will be alive after 2 years. Over recent years, several teams have obtained encouraging results after surgical resection of hepatic metastases. The aim of the present study was to evaluate the number of patients likely to require resection of hepatic metastases in a serie of 180 cases of colo-rectal cancer. 57 patients (30 p. cent) already had hepatic metastases at the time of the gastro-intestinal resection and only 3 underwent a simultaneous metastasectomy. In the other cases, the extent of the disease or the general condition of the patients contra-indicated a 2-stage resection. Among the 126 patients free of metastases at the time of the operation, 40 p. cent would have been excluded from hepatic resection in the event of secondary development of metastases because of the general clinical state. 75 patients were suitable for post-operative surveillance of hepatic metastases. We calculated that 20 of them might develop a hepatic metastasis without local recurrence of the colo-rectal cancer in the 2 years following the colonic resection, although of course we were unable to predict the type of metastasis or its accessibility to surgery. These figures may be useful as a guide to the development of a surveillance strategy.