BACKGROUND: Some 75-80 per cent of patients undergoing liver resection for colorectal liver metastases develop intrahepatic recurrence. A significant number of these can be considered for repeat liver surgery. This study examined the outcomes of repeat liver resection for the treatment of recurrent colorectal metastases confined to the liver. METHODS: Patients who underwent repeat liver resection in a single tertiary referral hepatobiliary centre were identified from a database. Clinicopathological variables were analysed to assess factors predictive of survival. RESULTS: A total of 195 patients underwent repeat resection between 1993 and 2010. Median age was 63 years, and the median interval between first and repeat resection was 13·8 months. Thirty-three patients (16·9 per cent) underwent completion hemihepatectomy or extended hemihepatectomy and the remainder had non-anatomical or segmental resection. The 30-day mortality rate was 1·5 per cent, and the overall 30-day morbidity rate was 20·0 per cent. Overall 1-, 3- and 5-year survival rates were 91·2, 44·3 and 29·4 per cent respectively. Tumour size 5 cm or greater was the only independent predictor of overall survival (relative risk 1·71, 95 per cent confidence interval 1·08 to 2·70; P = 0·021). Neoadjuvant chemotherapy before resection, perioperative blood transfusion, bilobar disease, R1 resection margin and multiple metastases were among factors that did not significantly influence survival. CONCLUSION: Repeat hepatic resection remains the only curative option for patients presenting with recurrent colorectal liver metastases.
BACKGROUND: Some 75-80 per cent of patients undergoing liver resection for colorectal liver metastases develop intrahepatic recurrence. A significant number of these can be considered for repeat liver surgery. This study examined the outcomes of repeat liver resection for the treatment of recurrent colorectal metastases confined to the liver. METHODS:Patients who underwent repeat liver resection in a single tertiary referral hepatobiliary centre were identified from a database. Clinicopathological variables were analysed to assess factors predictive of survival. RESULTS: A total of 195 patients underwent repeat resection between 1993 and 2010. Median age was 63 years, and the median interval between first and repeat resection was 13·8 months. Thirty-three patients (16·9 per cent) underwent completion hemihepatectomy or extended hemihepatectomy and the remainder had non-anatomical or segmental resection. The 30-day mortality rate was 1·5 per cent, and the overall 30-day morbidity rate was 20·0 per cent. Overall 1-, 3- and 5-year survival rates were 91·2, 44·3 and 29·4 per cent respectively. Tumour size 5 cm or greater was the only independent predictor of overall survival (relative risk 1·71, 95 per cent confidence interval 1·08 to 2·70; P = 0·021). Neoadjuvant chemotherapy before resection, perioperative blood transfusion, bilobar disease, R1 resection margin and multiple metastases were among factors that did not significantly influence survival. CONCLUSION: Repeat hepatic resection remains the only curative option for patients presenting with recurrent colorectal liver metastases.
Authors: F Navarro-Freire; P Navarro-Sánchez; N García-Agua; B Pérez-Cabrera; A Palomeque-Jiménez; J A Jiménez-Rios; P A García-López; A J García-Ruiz Journal: Clin Transl Oncol Date: 2015-03-17 Impact factor: 3.405
Authors: Hannes P Neeff; Oliver Drognitz; Philipp Holzner; Andrea Klock; Peter Bronsert; Ulrich T Hopt; Frank Makowiec Journal: Int J Colorectal Dis Date: 2013-03-07 Impact factor: 2.571
Authors: Elisabeth Gasser; Eva Braunwarth; Marina Riedmann; Benno Cardini; Nikolaus Fadinger; Jaroslav Presl; Eckhard Klieser; Philipp Ellmerer; Aurélien Dupré; Katsunori Imai; Hassan Malik; Hideo Baba; Hanno Ulmer; Stefan Schneeberger; Dietmar Öfner; Adam Dinnewitzer; Stefan Stättner; Florian Primavesi Journal: PLoS One Date: 2019-05-31 Impact factor: 3.240
Authors: Hannah Voß; Marcus Wurlitzer; Daniel J Smit; Florian Ewald; Malik Alawi; Michael Spohn; Daniela Indenbirken; Maryam Omidi; Kerstin David; Hartmut Juhl; Ronald Simon; Guido Sauter; Lutz Fischer; Jakob R Izbicki; Mark P Molloy; Björn Nashan; Hartmut Schlüter; Manfred Jücker Journal: Clin Exp Metastasis Date: 2020-10-24 Impact factor: 5.150