TY - CHAP M1 - Book, Section TI - LOCAL RESECTION OF HEPATIC TUMOR (NONANATOMIC) A1 - Ellison, E. Christopher A1 - Zollinger, Robert M. Y1 - 2016 N1 - T2 - Zollinger's Atlas of Surgical Operations, 10e AB - A persistent rise in the carcinoembryonic antigen (CEA) level measured every 2 to 3 months during the postoperative years following resection of a colorectal malignancy is an indication for a thorough search for a possible recurrence. The original operation and pathologic reports are reviewed because they may provide a clue as to where the recurrence is located. A complete survey of the colon and rectum is done and the liver is fully studied with liver function tests and imaging scans (CT, MRI, PET-CT) as it is the principal site for metastatic disease Evidence of metastases to the lungs or diffuse involvement of the abdomen or bone generally contraindicates surgical intervention, but local excision is usually considered in a good risk patient with a definite steady increase in the CEA level. Further, a hepatic lobectomy may be considered for a metastasis too large for local excision. The 5-year survival rates following the removal of hepatic metastases tend to be encouraging. The patient should be fully informed of the uncertainty of being cured of recurrence of malignancy. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesssurgery.mhmedical.com/content.aspx?aid=1127273428 ER -