I read with interest the article by Assumpcao and colleagues, assessing outcomes for patients with hepatic metastases from rectal adenocarcinoma primary tumors. Rectal adenocarcinoma is often lumped with colon cancer; however, treatment, pattern of recurrence, and outcome can be quite different. Only 24% of hepatic resections in the current study were in patients with a primary rectal tumor site, whereas the rectum represents the primary site for nearly 33% of all colorectal cancer cases. This disparity has been demonstrated1 and may stem from the increased complexity of treating patients with rectal cancer, which makes them less suitable for combined or subsequent partial hepatectomy.
Kooby DA. Patterns of Recurrence Following Liver Resection for Colorectal Metastases—Invited Critique. Arch Surg. 2008;143(8):749-750. doi:10.1001/archsurg.143.8.749