Surgical resection of hepatic metastases from colorectal cancer: a systematic review of published studies.

摘要: No consensus on the indications for surgical resection of colorectal liver metastases exists. This systematic review has been undertaken to assess published evidence its efficacy and safety identify prognostic factors. Studies were identified by computerised hand searches literature, scanning references contacting investigators. The outcome measures overall survival, disease-free postoperative morbidity mortality, quality life cost effectiveness, a qualitative summary trends across all studies was produced. Only 30 529 independent met eligibility criteria review, data 30-day mortality only included from further nine studies. best available came prospective case series, but two reported outcomes patients undergoing surgery. remainder selected groups patients: those hepatic or curative resection. Postoperative rates generally low (median 2.8%). majority described serious morbidity, most common being bile leak associated perihepatic abscess. Approximately 30% remained alive 5 years after around two-thirds these are disease free. papers poor ascertaining benefits is difficult in absence randomised trials. However, it clear that there group with who may become long-term disease- free survivors following Such survival rare apparently comparable do not have treatment. Further work needed more accurately define this determine whether addition adjuvant treatments results improved survival.