Faculty Collaboration Database

Repeat hepatic resection for colorectal liver metastases. Br J Surg 2012 Sep;99(9):1278-83

Date

08/07/2012

Pubmed ID

22864889

DOI

10.1002/bjs.8845

Scopus ID

2-s2.0-84864682546 (requires institutional sign-in at Scopus site)   49 Citations

Abstract

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.

Author List

Adair RA, Young AL, Cockbain AJ, Malde D, Prasad KR, Lodge JP, Toogood GJ

Author

Kondragunta Rajendra Prasad MBBS Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols
Blood Transfusion, Autologous
Catheter Ablation
Chemotherapy, Adjuvant
Colorectal Neoplasms
Disease-Free Survival
Female
Hepatectomy
Humans
Liver Neoplasms
Male
Middle Aged
Neoplasm Recurrence, Local
Postoperative Complications
Prospective Studies
Reoperation
Young Adult