Faculty Collaboration Database

Repeat liver resection for recurrent colorectal metastases: a single-centre, 13-year experience. HPB (Oxford) 2014 Feb;16(2):157-63

Date

03/28/2013

Pubmed ID

23530978

Pubmed Central ID

PMC3921011

DOI

10.1111/hpb.12096

Scopus ID

2-s2.0-84892600602 (requires institutional sign-in at Scopus site)   53 Citations

Abstract

OBJECTIVES: Isolated intrahepatic recurrence is noted in up to 40% of patients following curative liver resection for colorectal liver metastases (CLM). The aims of this study were to analyse the outcomes of repeat hepatectomy for recurrent CLM and to identify factors predicting survival.

METHODS: Data for all liver resections for CLM carried out at one centre between 1998 and 2011 were analysed.

RESULTS: A total of 1027 liver resections were performed for CLM. Of these, 58 were repeat liver resections performed in 53 patients. Median time intervals were 10.5 months between the primary resection and first hepatectomy, and 15.4 months between the first and repeat hepatectomies. The median tumour size was 3.0 cm and the median number of tumours was one. Six patients had a positive margin (R1) resection following first hepatectomy. There were no perioperative deaths. Significant complications included transient liver dysfunction in one and bile leak in two patients. Rates of 1-, 3- and 5-year overall survival following repeat liver resection were 85%, 61% and 52%, respectively, at a median follow-up of 23 months. R1 resection at first hepatectomy (P = 0.002), a shorter time interval between the first and second hepatectomies (P = 0.02) and the presence of extrahepatic disease (P = 0.02) were associated with significantly worse overall survival.

CONCLUSIONS: Repeat resection of CLM is safe and can achieve longterm survival in carefully selected patients. A preoperative knowledge of poor prognostic factors helps to facilitate better patient selection.

Author List

Battula N, Tsapralis D, Mayer D, Isaac J, Muiesan P, Sutcliffe RP, Bramhall S, Mirza D, Marudanayagam R

Author

Narendra Battula MD Associate 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
Colorectal Neoplasms
Disease-Free Survival
Female
Follow-Up Studies
Hepatectomy
Humans
Kaplan-Meier Estimate
Liver Neoplasms
Male
Middle Aged
Neoplasm Recurrence, Local
Neoplasm Staging
Patient Selection
Proportional Hazards Models
Reoperation
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
Victoria