OUTCOMES FOR LIVER SURGERY FOR COLORECTAL SECONDARIES AT THE ROYAL SURREY COUNTY HOSPITAL, GUILDFORD.

Since 1997, liver surgery at the Royal Surrey County Hospital, Guildford, has produced long term results that are amongst the best in the world literature. The following table and survival curve outline some of those results.

Long term results following liver surgery at the Royal Surrey County Hospital, Guildford.

Showing results for Liver Resections for Bowel Cancer which has Spread to the Liver

* This means cancer is found at the edge of the cut surface of the liver when looked at under a microscope. If cancer cells are found here, it means some cancer may have been left behind. It is impossible to remove all the cancer in all the patients. However, our rate of completely removing all the cancer is highest in the world-wide literature. This is one factor which has lead to the highest overall and disease-free survival in the world-wide literature today.

Overall survival is influenced by our multi-disciplinary team, which includes liver surgeons, liver physicians, specialist radiologists, pathologists, oncologists (cancer specialists), specialist nurses and dieticians.

It is by working as a team that results like these can be achieved.

Current Research into secondary liver cancer

Surgery vs. Radiofrequency Ablation

Through research we are constantly moving the boundaries of treatment, to help us improve existing treatments and develop new treatments in the battle against cancer.

One area of research that we are looking into is to compare surgery with radio-frequency ablation, or RFA, for tumours in the liver that have spread from the bowel. RFA is when a probe is placed into the liver at the site of the tumour. A current is then passed through it which generates heat up to 1000C. This destroys the cancer cells. However, the heat is generated locally which means there is very little surrounding damage. It may be that RFA is as good as surgery with long term survival from this type of cancer, but without the trauma of going through major surgery. We are currently testing this theory.

Gene Expression Profile

At the Royal Surrey County Hospital, we work very closely with scientists at the neighbouring University of Surrey. In one such collaboration, we are investigating the gene expression profile of cancer that has spread from the bowel to the liver.

All cells that contain DNA contain all the genes to make up an individual. When a cell becomes a cancer, those genes change in complex ways. We have the technology at the University of Surrey to examine each gene using a technique called microarray analysis. Through this we can look at 46,000 genes on a quarter of a slide. This slide is then passed into a machine that can read the data and tell us how over active or underactive each gene is.

This research may enable us to better understand bowel cancer within the liver, and possibly better tailor treatments for individual patients.

Relevant Papers

1. Karanjia N.D., Lordan J.T., Quiney N, Fawcett W.J., Worthington T.R., Remington J. A comparison of right and extended right hepatectomies with all other hepatic resections for colorectal liver metastases - a ten year study. European Journal of Surgical Oncology. 2009; 35: 65-70.

2. Lordan J.T, Karanjia N.D, Quiney N, Fawcett W.J., Worthington T.R. A 10 year study of outcome following hepatic resection for colorectal liver metastases - The effect of evaluation in a multi-disciplinary team setting. European Journal of Surgical Oncology. 2009; 35: 302-306.

3. Karanjia N.D, Lordan J.T, Fawcett W.J, Quiney N, Worthington T.R. Survival and Recurrence After Neo-adjuvant Chemotherapy and Liver Resection for Colorectal Metastases - A Ten Year Study. European Journal of Surgical Oncology. 2009; In Press.

4. Lordan J.T., Worthington T.R., Quiney N, Fawcett W.J., Karanjia N.D. Early post-operative outcomes following hepatic resection for benign liver disease in 79 consecutive patients. HPB (In Press).

5. Lordan J.T, Karanjia N.D. 'Close Shave' in liver resection for colorectal liver metastases. European Journal of Surgical Oncology. 2009; (In Press)