By Suzanne Rostler

NEW YORK, Mar 26 (Reuters Health) - Patients with colorectal cancer that has spread to the liver may have the best chance of survival if their disease is treated surgically, a new report suggests.

Doctors are often concerned about the risks of surgery for these patients and have instead opted for other treatments such as chemotherapy, lead author Dr. Martin J. Heslin told Reuters Health. Risks of surgery include bleeding, infection and liver failure.

But in Heslin's study of 174 patients with colon cancer that had spread to the liver, those who had surgery survived for 70 months, on average. Only the patients who had the surgery survived for longer than 5 years. Those treated with an implanted pump that delivered chemotherapy drugs directly to the liver lived for 32 months, while those whose tumors could not be removed surgically lived for an average of 3 months, according to the report in the March issue of Archives of Surgery.

"We recommend an aggressive approach to the surgical management of patients with isolated colorectal hepatic metastases," said Heslin, a surgical oncologist from the University of Alabama, Birmingham. "In years past, many physicians...have been concerned with the safety of surgery and have recommended chemotherapy alone. In some cases this is appropriate, however, in other cases surgical resection (removal) would give the patient a greater chance of cure."

Colorectal cancer that has spread to the liver can also be treated by freezing or "cooking" the tumor with microwaves, delivering chemotherapy directly to the liver with an implanted pump, regular chemotherapy or surgery, he explained.

Heslin stressed that not all patients are candidates for surgery, and recommended that all patients with metastatic colorectal cancer be evaluated by a multidisciplinary team of doctors to determine the most appropriate treatment.

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• Liver Cancer