RT Book, Section A1 Ellison, E. Christopher A1 Zollinger, Robert M. SR Print(0) ID 1127273428 T1 LOCAL RESECTION OF HEPATIC TUMOR (NONANATOMIC) T2 Zollinger's Atlas of Surgical Operations, 10e YR 2016 FD 2016 PB McGraw-Hill Education PP New York, NY SN 978-0-07-179755-9 LK accesssurgery.mhmedical.com/content.aspx?aid=1127273428 RD 2024/03/28 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.