BACKGROUND: Repeat liver resection because of recurrent colorectal liver metastases can provide survival benefit with a low rate of complications. DESIGN: Retrospective study. PARTICIPANTS: Forty patients who underwent a second hepatectomy because of liver metastases from colorectal cancer. MAIN OUTCOME MEASURES: Short- and long-term results of a second hepatectomy and determination of prognostic factors. RESULTS: The postoperative mortality rate was 2.5%. The postoperative morbidity rate was not significantly different after a second hepatectomy compared with single hepatectomy (42.5% and 27.5%, respectively; P = .10). Transfusion requirement and hospital stay were comparable for both a single and a second hepatectomy. Three- and 5-year overall survival rates were 55% and 31%, respectively. Disease-free survival rates at 3 and 5 years were, respectively, 49% and 27%. The interval between first and second hepatectomies and the presence of extrahepatic disease were independently related to survival (multivariate analysis). CONCLUSIONS: A second liver resection because of recurrent liver metastases from colorectal cancer is safe and provides a survival benefit similar to that with single hepatectomy. Our analysis suggests that the benefit of treatment is limited in patients who undergo a second hepatectomy within 1 year of the first operation and in those with extrahepatic disease.
BACKGROUND: Repeat liver resection because of recurrent colorectal liver metastases can provide survival benefit with a low rate of complications. DESIGN: Retrospective study. PARTICIPANTS: Forty patients who underwent a second hepatectomy because of liver metastases from colorectal cancer. MAIN OUTCOME MEASURES: Short- and long-term results of a second hepatectomy and determination of prognostic factors. RESULTS: The postoperative mortality rate was 2.5%. The postoperative morbidity rate was not significantly different after a second hepatectomy compared with single hepatectomy (42.5% and 27.5%, respectively; P = .10). Transfusion requirement and hospital stay were comparable for both a single and a second hepatectomy. Three- and 5-year overall survival rates were 55% and 31%, respectively. Disease-free survival rates at 3 and 5 years were, respectively, 49% and 27%. The interval between first and second hepatectomies and the presence of extrahepatic disease were independently related to survival (multivariate analysis). CONCLUSIONS: A second liver resection because of recurrent liver metastases from colorectal cancer is safe and provides a survival benefit similar to that with single hepatectomy. Our analysis suggests that the benefit of treatment is limited in patients who undergo a second hepatectomy within 1 year of the first operation and in those with extrahepatic disease.
Authors: Julie Hallet; Antonio Sa Cunha; Daniel Cherqui; Brice Gayet; Diane Goéré; Philippe Bachellier; Alexis Laurent; David Fuks; Francis Navarro; Patrick Pessaux Journal: World J Surg Date: 2017-12 Impact factor: 3.352
Authors: Afif N Kulaylat; Neil H Bhayani; Audrey L Stokes; Jane R Schubart; Joyce Wong; Eric T Kimchi; Kevin F Staveley-O'Carroll; Jussuf T Kaifi; Niraj J Gusani Journal: J Gastrointest Surg Date: 2014-06-21 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