Extensive hepatic resections with preoperative regional chemotherapy for metastases of colorectal carcinoma
Objective. To study efficacy of extensive hepatic resections with preoperative regional chemotherapy for metastases of colorectal carcinoma. Material and methods. The analysis of results for extensive hepatic resections with preoperative regional intra-arterial chemotherapy in 106 patients with colorectal liver metastases was performed. 64 (60%) patients had bilobate metastases, 50 (47%) patients had multiple metastases, 22 (21%) patients had liver metastases as well as extrahepatic metastases that were also excised. Results. Bevacizumab in preoperative regional chemotherapy did not lead to increase of intraoperative hemorrhage, frequency of postoperative complications. Frequency of development of hepatic failure in operated patients was 37%, biliary fistulas was 11%. Preoperative multi-course regional chemotherapy was in 5 (4.7%) patients with multiple metastases and lesion of 7 liver segments i.e. with unresectable metastatic cancer allowed us to reduce the volume of lesion in organ and perform radical hepatic resection. Conclusion. Significantly worse long-term results were in patients with multiple liver metastases, metastases in lymph nodes of hepatoduodenal ligament. The distance between the border of hepatic resection and edge of tumour was less than 1 sm.