AIM: Our aim was to determine independent predictors of survival after second liver resection and to confirm whether the type of first resection influences survival after repeat resection. METHODS: Fifty-four patients who underwent a second liver resection for colorectal liver metastases were analyzed. To find independent predictors of survival, possible prognostic factors regarding the primary tumor, and the first and second resections were used in the Cox regression analysis. RESULTS: There were three postoperative deaths within 90 days of surgery. The 3- and 5-year overall survival rates were 53% and 46%, respectively. The size of the tumor (>50mm) (p=0.005), serum carcinoembryonic antigen level (>30microg/L) (p=0.002), and the presence of a positive surgical margin at the second resection (p=0.006) were independent predictors of poor survival following the second resection. The type of first resection was not associated with survival but was associated with the ability to achieve a histological negative surgical margin at the second liver resection (p=0.01). CONCLUSION: Three independent predictors of survival were identified. Major initial liver resection was associated with a reduced ability to achieve surgical clearance at the second resection. For colorectal liver metastases, major resection should only be performed if a negative margin cannot be achieved by minor resection.
AIM: Our aim was to determine independent predictors of survival after second liver resection and to confirm whether the type of first resection influences survival after repeat resection. METHODS: Fifty-four patients who underwent a second liver resection for colorectal liver metastases were analyzed. To find independent predictors of survival, possible prognostic factors regarding the primary tumor, and the first and second resections were used in the Cox regression analysis. RESULTS: There were three postoperative deaths within 90 days of surgery. The 3- and 5-year overall survival rates were 53% and 46%, respectively. The size of the tumor (>50mm) (p=0.005), serum carcinoembryonic antigen level (>30microg/L) (p=0.002), and the presence of a positive surgical margin at the second resection (p=0.006) were independent predictors of poor survival following the second resection. The type of first resection was not associated with survival but was associated with the ability to achieve a histological negative surgical margin at the second liver resection (p=0.01). CONCLUSION: Three independent predictors of survival were identified. Major initial liver resection was associated with a reduced ability to achieve surgical clearance at the second resection. For colorectal liver metastases, major resection should only be performed if a negative margin cannot be achieved by minor resection.
Authors: Anand Govindarajan; Dean Arnaoutakis; Michael D'Angelica; Peter J Allen; Ronald P DeMatteo; Leslie H Blumgart; William R Jarnagin; Yuman Fong Journal: J Gastrointest Surg Date: 2011-05-10 Impact factor: 3.452
Authors: Giovanni Brandi; Jody Corbelli; Francesco de Rosa; Stefania Di Girolamo; Ciro Longobardi; Valentina Agostini; Ingrid Garajová; Stefano La Rovere; Giorgio Ercolani; Gian Luca Grazi; Antonio Daniele Pinna; Guido Biasco Journal: Langenbecks Arch Surg Date: 2012-06-19 Impact factor: 3.445
Authors: Vincent W T Lam; Tony Pang; Jerome M Laurence; Emma Johnston; Michael J Hollands; Henry C C Pleass; Arthur J Richardson Journal: J Gastrointest Surg Date: 2013-03-23 Impact factor: 3.452
Authors: Oliver Ziff; Ibrahim Rajput; Robert Adair; Giles J Toogood; K Rajendra Prasad; J Peter A Lodge Journal: HPB (Oxford) Date: 2013-07-22 Impact factor: 3.647