BACKGROUND: We critically appraised the quantity and quality of current clinical evidence to demonstrate the efficacy and safety of repeat hepatectomy for recurrent colorectal liver metastases (CRLM). METHODS: Electronic searches for relevant studies published in peer-reviewed medical journals on repeat hepatectomy for recurrent CRLM before January 2007 were performed on six databases. The quality of each included study was independently assessed. Clinical effectiveness was synthesized through a narrative review with full tabulation of results of all included studies. RESULTS: Seventeen studies with more than 20 patients were included for quality appraisal and data extraction. All 17 included articles were observational cases series. The overall perioperative morbidity rate ranged from 7% to 30% and mortality rate varied from 0% to 5%. The overall median survival since the repeat hepatectomy ranged from 23 to 56 months, with 3- and 5-year survival of 24% to 68% and 21% to 49%, respectively. The median disease-free survival ranged from 9 to 52 months, with 3- and 5-year disease-free survival of 16% to 68% and 16% to 48%, respectively. CONCLUSIONS: The current literature suggests that repeat hepatectomy is associated with a prolonged survival for recurrent CRLM and is justified in selected patients because there is a lack of evidence for effective alternative treatments.
BACKGROUND: We critically appraised the quantity and quality of current clinical evidence to demonstrate the efficacy and safety of repeat hepatectomy for recurrent colorectal liver metastases (CRLM). METHODS: Electronic searches for relevant studies published in peer-reviewed medical journals on repeat hepatectomy for recurrent CRLM before January 2007 were performed on six databases. The quality of each included study was independently assessed. Clinical effectiveness was synthesized through a narrative review with full tabulation of results of all included studies. RESULTS: Seventeen studies with more than 20 patients were included for quality appraisal and data extraction. All 17 included articles were observational cases series. The overall perioperative morbidity rate ranged from 7% to 30% and mortality rate varied from 0% to 5%. The overall median survival since the repeat hepatectomy ranged from 23 to 56 months, with 3- and 5-year survival of 24% to 68% and 21% to 49%, respectively. The median disease-free survival ranged from 9 to 52 months, with 3- and 5-year disease-free survival of 16% to 68% and 16% to 48%, respectively. CONCLUSIONS: The current literature suggests that repeat hepatectomy is associated with a prolonged survival for recurrent CRLM and is justified in selected patients because there is a lack of evidence for effective alternative treatments.
Authors: Dimitrios Moris; Sean Ronnekleiv-Kelly; Amir A Rahnemai-Azar; Evangelos Felekouras; Mary Dillhoff; Carl Schmidt; Timothy M Pawlik Journal: J Gastrointest Surg Date: 2017-03-31 Impact factor: 3.452
Authors: Narendra Battula; Dimitrios Tsapralis; David Mayer; John Isaac; Paolo Muiesan; Robert P Sutcliffe; Simon Bramhall; Darius Mirza; Ravi Marudanayagam Journal: HPB (Oxford) Date: 2013-03-27 Impact factor: 3.647
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