During an operation for carcinoma of the hepatic flexure of the colon, an unexpected discontinuous 3-cm metastasis is discovered in the edge of the right lobe of liver. The surgeon should
Because approximately 5% of colorectal cancers are associated with resectable hepatic metastases, appropriate preoperative- discussion should include obtaining permission for removal of synchronous peripheral hepatic lesions if they are found. If gross tumor is removed, a 25% cure rate can be anticipated. Adequate local resection, either by wedge or by limited partial hepatectomy, may be carried out whenever no extrahepatic disease is found and the hepatic lesion is technically removable. Any option that leaves the potentially obstructing primary cancer unremoved would be unacceptable.
Terminate the operation, screen the patient for evidence of other metastases, and plan further therapy after the reevaluation
Perform a right hemicolectomy and right hepatic lobectomy
Perform a right hemicolectomy and a wedge resection of metastasis
Perform a cecostomy and schedule reoperation after a course of systemic chemotherapy