MODERN APPROACH TO TREATMENT OF COLORECTAL CANCER PATIENTS WITH LIVER METASTASES (LITERATURE REVIEW)
We performed an analysis of long-term results of treatment 268 patients with colorectal cancer (CRC) with synchronous liver metastases. The patients were divided into 4 groups: group 1 (n = 11) - patients who received only symptomatic treatment (all bilobar multiple metastases); group 2 (n = 58), patients with liver metastases who received only polychemotherapy; group 3 (n = 134) - patients who had palliative surgery (removal of only the primary tumor without removing metastases); group 4 (n = 65) - patients who underwent cytoreductive surgery. Median survival was: group 1 - 5.4 months; 2nd group - 13.0 months; group 3 - 16.8 months (3-year cumulative survival rate - 5.2%); 4 group - 35.5 months (5-year survival rate - 30.8%). In the latter group, the 5-year survival of patients with solitary metastases stood significantly higher than that in the subgroups with single and multiple metastases. Subgroup of patients (group 4), who underwent anatomic resection of the liver showed a better cumulative survival rate in all periods of the study, compared to a subgroup of patients (from the same group) who underwent liver atypic resection. At all levels of survival time of patients who performed cytoreductive surgery (Group 4), were significantly higher compared to those in the group of patients who performs palliative surgery (Group 3). Multivariate regression analysis showed that the most important prognostic factors in patients with colorectal cancer are number and size of metastases and the presence bilobar lesions, as well as low-grade tumor, tumor in the rectum and the patient’s age. Refs 42.