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.
