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Multiple Resections for Liver and Lung Metastases?

Removing Colon Cancer that has Spread to the Liver and Lungs in One Fell Swoop

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Updated: May 25, 2007

When colorectal cancer metastasizes (spreads), the liver and lungs are two of its favorite destinations. That leaves a lot of people with stage 4 colon cancer trying to decide what treatment is best for them. A study published in the Japanese Journal of Clinical Oncology offered a potential option: One long surgery to remove any operable tumors that have spread to the lungs and liver. The medical term for it is "multiple resections" because the surgery involves removing the diseased pieces and rejoining the healthy parts together.

According to the study, the medical community doesn't have clearly-defined criteria for determining who the best candidates are for this two-in-one procedure, and hasn't determined the best way to treat patients whose cancer returns after the multiple resections. So, the researchers performed this study with the goal of answering those two questions: "For whom is this procedure best suited?" and "What should be done if someone has a recurrence after receiving this procedure?"

Did the Multiple Resections Work?

After reviewing data from 30 patients, the researchers determined that the procedure is safe and effective and if the cancer should recur, removing it with another resection is recommended. It's important to note that 30 people is a small sample size, so it's best to view this study as one opinion on the matter instead of a definitive answer.

Limitations of the Study

Since the participants in this study were Japanese, the results might not be applicable to the average American. This is because genetic factors can influence patients' outcomes. There are other considerations as well. According to limited published experience, how soon the metastases show up after the initial colon cancer diagnosis has a significant impact on whether a multiple resection would be effective. Finding a skilled surgeon who has extensive experience with multiple resections would also be a critical factor.

How the Study May Apply to You

You can't really use this study to make a treatment decision, but you can use it as a topic of discussion with your oncologist. If you have multiple metastases and the idea of one long surgery appeals to you, simply ask your doctor if she thinks it's a good idea. And remember, always ask for an explanation and if your doctor is dismissive, feel free to seek a second opinion. You have the right to actively participate in your care, and that includes exploring all of your treatment options.

Source: Takahashi, S. and Nagai, K. Multiple Resections for Hepatic and Pulmonary Metastases of Colorectal Carcinoma." Japanese Journal of Clinical Oncology 37.3 (2007): 186-192. Accessed 5 May 2007.

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