Twenty-five-year follow-up for liver resection: the personal series of Dr. Joseph G. Fortner.

Abstract

Liver resection is performed for many types of malignancies. Few reports document actual long-term survival. Long-term follow-up of a series of 548 liver resections performed between 1970 and 1992 was performed and is presented. All patients were followed for at least 15 years after surgery. Of the 476 cancer patients, the 5-, 10-, 15-, and 20-year survival rates were 38%, 25%, 20%, and 17%, respectively. Within this group, 108 and 88 patients were actual 10- and 15-year survivors, respectively. Median survival time in months varied by tumor type: metastatic neuroendocrine (81 months), biliary cancer (cholangiocarcinoma) (63 months), gallbladder cancer (47 months), metastatic colorectal cancer (40 months), and hepatocellular carcinoma (27 months). Survivors of each tumor type living more than 25 years were documented. Patients disease-free 10 years after resection for metastatic colorectal cancer or gallbladder cancer were usually considered cured. Patients with diagnoses of hepatocellular carcinoma, cholangiocarcinoma, or other metastases (including neuroendocrine tumors or sarcomas) continued to recur and die of disease. Liver resection can be performed with long-term survival and potential curative outcome in a variety of primary and metastatic cancers of the liver.