Annals of Surgical Oncology

, Volume 19, Issue 6, pp 2035–2044 | Cite as

Evolution of Long-Term Outcome of Liver Resection for Colorectal Metastases: Analysis of Actual 5-Year Survival Rates over Two Decades

  • Luca Viganò
  • Nadia Russolillo
  • Alessandro Ferrero
  • Serena Langella
  • Elisa Sperti
  • Lorenzo Capussotti
Hepatobiliary Tumors



Liver resection (LR) is the only potentially curative treatment of colorectal liver metastases (CRLM). Its outcome over the past 2 decades was studied using actual 5-year survival rates.


Data of 393 consecutive patients who underwent LR for CRLM at Mauriziano Umberto I (Turin) until June 2005 were analyzed. Excluding R2 resections (n = 4) or incomplete 5-year follow-up (n = 13), 376 patients were divided according to LR date into groups A (before 1995: 90 patients), B (1995–2000: 94 patients), C (2001–2005: 192).


Group C presented increased multiple and bilobar metastases compared with combined group A and B (C vs AB: 54.7% vs 40.2%, P = 0.005; 28.1% vs 19.0%, P = 0.038, respectively), decreased metastases diameter (C vs AB: 32 vs 40 mm, P = 0.0001). The 5-year overall survival, calculated excluding 4 operative mortalities (group AB), increased over the years (A, 20.5%; B, 32.6%; C, 46.4%; P < 0.0001). Early recurrences (1 year) were not decreased, extrahepatic recurrences even increased (C vs AB: 17.2% vs 8.6%, P = 0.015). Recurrence-free 5-year survival improved (C vs AB: 23.4% vs 13.9%, P = 0.019) linked to decreased liver recurrences (C vs AB: 26.8% vs 37.4%, P = 0.023). Resection rate (59% overall for liver recurrence) increased along with 5-year survival after recurrence (A, 4.0%; B, 14.2%; C, 21.4%; P < 0.0001). Survival improvement was confirmed for multiple (P = 0.003) and synchronous metastases (P = 0.008), N+ tumors (P = 0.005), and in patients without chemotherapy (P = 0.001).


Long-term outcome of LR for CRLM improved over 20 years, even in patients with negative prognostic factors, linked to hepatic recurrences reduction and increased survival after recurrence.


Liver Resection Negative Prognostic Factor Synchronous Metastasis Liver Recurrence Extrahepatic Recurrence 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors are extremely grateful to Prof Claire de Burbure for revising the manuscript.

Conflict of interest

None to declare.


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Copyright information

© Society of Surgical Oncology 2011

Authors and Affiliations

  • Luca Viganò
    • 1
  • Nadia Russolillo
    • 1
  • Alessandro Ferrero
    • 1
  • Serena Langella
    • 1
  • Elisa Sperti
    • 2
  • Lorenzo Capussotti
    • 1
  1. 1.Department of HPB and Digestive SurgeryOspedale Mauriziano Umberto ITurinItaly
  2. 2.Department of OncologyOspedale Mauriziano Umberto ITurinItaly

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