Outcomes of Liver Surgery under Prof. Karanjia

Liver Resections at the Hepato-pancreato-biliary Unit, for Surrey and Sussex, February 2009

Since 1996, liver surgery in 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.

Table showing long term results for liver resections for bowel cancer that has spread to the liver

Events Following Liver Resection (Removal of Part of the Liver)

Results at the HPB Unit in Guildford for Liver Resections for Bowel Cancer which has Spread to the Liver

World Wide Published Literature for Liver Resections for Bowel Cancer which has Spread to the Liver

Overall Survival at:


1 year



3 years



5 years


30% to 41%

Disease Free-Survival (Alive and the cancer has not come back) at:


1 year



3 years



5 years


19% to 28%

Mortality (death within 30 days of operation)



*Cancer Involved Resection Margins


8.8% to 33%

* 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.

Figure 1. CRC mets survival Aug 08.JPG
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

Treatment of Colorectal Liver Metastases by 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 100°C. 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 of Colorectal Liver Metastases

At the HBP Unit in Guildford, 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.