Results of surgical treatment of colorectal cancer liver metastases in Latvia oncology center.

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485 Background: Colorectal cancer (CRC) is the third leading cause of cancer death. At the time of diagnosis 25% of patients present with stage IV disease and out of all CRC patients 50% develop liver metastases. About 15% of them have initially resectable disease. Surgical resection is the best treatment option as it is associated with longer survival. Latvia Oncology center (LOC) provide expertise in managment of all cancers, including metastatic CRC. Methods: Data about CRC patients with surgicaly treated liver metastases was colected and analysed from Latvia Oncology center in period 2011-2014. This data is also included in LiverMetSurvey international registry of patients operated for CRC liver metastases. 66 patients underwent hepatectomies, 10 patients had 2 or more surgeries due to a reccurent disease. Results: 77 surgeries were performed, 31 were hemihepatectomies and 46 were limited resections. Sinchronous surgery for liver metastases and primary tumor were performed in 19 cases: 11 for left colon cancer, 6 for rigt colon cancer and 2 for rectal cancer. Initially resectable liver disease was found in 70 cases. Unilateral metastases were diagnosed in 61 cases while there were 17 cases of bilateral disease. Postoperative complications developed in 18 patients, 5 of those after sinchronous surgeries for primary tumor. In 10 cases complications developed after major anatomical right sided hemihepatectomy and in 8 cases after atypical resections. Most frequent hepatic complications were infected collection in hepatic loge (n=9), non infected collection (n=3) and biliary leak (n=3); all of those were successfully treated with percutaneous dreinage. 1 patient died due to a postoperative liver insufficiency after right sided hemihepatectomy for recurrent disease. Conclusions: Overall 77 hepatectomies were performed, mostly limited non anatomical resections. In majority of patients 1 or 2 metastases were diagnosed. Initally resectable were 89% of cases. Mass of postoperative complications developed after major hepatectomies, were liver related and successfully treated with minimally invasive procedures. Complication rate (16%) in LOC is comperable to other Europian centers.