title: [Repeat interventions in metastases].
abstract: Between 1985 and 1994, 262 patients with metastases underwent resectional treatment in the Department for General and Abdominal Surgery of the University of Mainz. Twenty-seven patients with recurrent metastases were treated with repeat resections. The records of these 27 patients were reviewed and analyzed. After 42 repeat resections, 4 of 27 patients (14.8%) developed complications. Three of 27 patients died in the postoperative period (11.1%). For patients with R0 resection of metastases from colorectal primaries the median survival time was 69 months after resection of the primary tumor (n = 16), 38 months after the first resection of metastases (n = 15), and 25 months after the second resection of metastases (n = 15). After the last repeat resection of metastases in each patient, median survival was 25 months in patients with R0 resection (n = 11), compared to 7 months following R1/2 resection (n = 5) (P = 0.007). Disease-free survival following first R0 resection of colorectal metastases (n = 15), was not significantly different from disease-free survival following repeated R0 resection of colorectal metastases (n = 21). Patients with repeat resection of colorectal liver metastases (n = 9) had longer disease-free survival (median 18 months) than patients with repeat resection of colorectal metastases in organs other than liver or lungs (median 4 months; n = 4) (P = 0.005). Repeat resections for metastases are characterized by low operative risk and a prognostic benefit for highly selected patients.
authors.affiliation: Klinik und Poliklinik für Allgemein- und Abdominalchirurgie, Johannes Gutenberg-Universität Mainz.
authors.forename: J K
authors.initials: JK
authors.lastname: Seifert
authors.forename: D
authors.initials: D
authors.lastname: Staupendahl
authors.forename: T
authors.initials: T
authors.lastname: Junginger
mesh_terms: D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality / Q000601:surgery; D012086:Reoperation; D015996:Survival Rate