Repeat resection of recurrent hepatic metastases--improvement in prognosis?
OBJECTIVE
To find out if resection of recurrent hepatic metastases improves survival.


METHODS
Retrospective study.


METHODS
University hospital, Germany.


METHODS
25 patients who had recurrent metastases after radical resection of hepatic metastases from colorectal and other primary carcinomas.


METHODS
Repeat liver resection with the intention to cure. Limited hepatic resections were preferred if they could be done without loss of radicality.


METHODS
Operative morbidity and mortality, survival time after second hepatic resection, analysis of possible prognostic factors.


RESULTS
Hemihepatectomy was done for 4 patients, and infiltration of the diaphragm led to extended resections in a further 4. Locoregional recurrence of rectal carcinoma together with a solitary pulmonary metastases in another patient were removed simultaneously. The remainder were limited resections. Seventeen procedures were regarded as radical. There were no operative deaths, and five patients developed minor complications. Actuarial survival rates after radical repeat liver resections were 94% after one year, 53% after two years, and 24% after three years. Radicality was the main prognostic factor of survival.


CONCLUSIONS
Repeat hepatic resections seem to improve prognosis and are recommended in patients with recurrent metastases confined to the liver.
Department of Surgery, Medical Faculty, Rhenish Westphalian Technical University, Aachen, Germany.
K P
KP
Riesener
R
R
Kasperk
G
G
Winkeltau
V
V
Schumpelick
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology; D005260:Female; D006498:Hepatectomy / Q000379:methods / Q000401:mortality*; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D011379:Prognosis; D012086:Reoperation; D012189:Retrospective Studies; D016019:Survival Analysis