Rectal Cancer: the Role of the Surgical Treatment of the Primary Tumor in Advanced Inoperable Liver Metastases

Abstract

The aim of the study was to determine the role of the surgical resection of the primary tumor in patients with rectal cancer and liver metastases who are not suitable for surgical treatment as part of their complex therapy.Materials and Methods: 74 patients who have undergone a rectal cancer surgery and had unresectable liver metastases were followed during a period of 10 years. Initially, all patients underwent radical resection of the primary tumor and then postoperative chemotherapy for treatment of the liver metastases. The participants were divided into two groups: the first group with survival of up to 8 months (median survival - 6 months) and the second group with survival longer than 8 months (median survival - 12 months). The following factors were analyzed: age, grading of the tumor, infiltration of the tumor into the wall of the rectum into the mesorectum, number of the metastases, localisation of the tumor into the rectum, type of the surgical intervention, as well as their influence over the survival.Results: The role of the surgical treatment of the primary tumor in patients with rectal cancer and inoperable liver metastases depends on the individual response of the patient to the postoperative chemotherapy. It is indicated by vital indications, young age and by the response to the preoperative chemotherapy. When there is lack of response to the preoperative chemotherapy the survival is the same with and without surgical treatment of the primary tumor.