Johns Hopkins Health Alert
Aggressive Treatment Pays Off
For patients with advanced, metastatic colorectal cancer that has spread to the liver, surgery offers hope, according to a study in the Annals of Surgical Oncology.
The treatments for advanced cancer are much the same as for newly diagnosed cancer. However, they are more aggressive. They include:
- Surgery to remove cancer where it has returned or metastasized. This could be localized or could involve extensive surgery for metastases in the liver or other organs.
- Radiation and/or chemotherapy to control and contain the cancer, especially if it is inoperable.
- Other techniques could involve freezing tumors (cryosurgery), burning them away with microwaves, or other methods of treating a well-defined area where a cancer is present.
Surgery for colorectal cancer that has spread to the liver results in good long-term survival rates, even for patients who have more than one metastasized tumor, according to a Canadian study reported in the Annals of Surgical Oncology (Volume 13, page 668).
Researchers reviewed the results of liver surgeries for metastatic colorectal cancer in 423 operations over a 10-year period at one cancer center, looking at the death rate from surgery, disease-free survival, and overall survival. More than half of the operations (65%) were major, involving more than four segments of the liver.
Overall, death and illness due to the operation were fairly rare: Seven patients died (1.6%) and 74 (17%) were sicker in connection with the surgery. In contrast, the disease-free survival rate at one year was 64%; at five years, 27%; and at 10 years post surgery, 22%. The overall and long-term survival rates were even better: 93%, 47%, and 28%, respectively.
Factors that predicted less successful outcomes included older age (patients over 60); surgical margins that tested positive for malignant cells; large metastatic tumors; and many metastases. However, researchers concluded that the overall good survival rates justify taking an aggressive surgical approach, even for patients with many metastases.
Posted in Colon Cancer on May 13, 2008
Reviewed September 2011
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