title: Repeat hepatectomy for recurrent colorectal metastases.
abstract: OBJECTIVE
  To determine the risks and benefits of repeat hepatectomy for hepatic metastases from colorectal cancer.
  
  
  METHODS
  During a recent 10-year-period, 106 patients underwent hepatectomy for hepatic metastases from colorectal cancer, in our hospital. Recurrence developed in the liver in 57 of these patients, 27 of whom underwent repeat hepatectomy. We reviewed the outcomes of these 27 patients.
  
  
  RESULTS
  There were three complications after the first hepatectomy and six complications after the second hepatectomy, but there was no perioperative mortality after the first or second hepatectomy. The median survival from the date of second hepatectomy was 41 months with an actuarial 5-year survival rate of 48.7%. Patients who underwent repeat hepatectomy had significantly higher survival rates from the time of first hepatectomy than those who did not. Univariate analysis showed that among the prognostic factors of repeat hepatectomy, only a disease-free interval (DFI) between the first and second hepatectomy of more than 1 year was significantly predictive of a better outcome (P = 0.047).
  
  
  CONCLUSIONS
  Repeat hepatectomy for recurrent colorectal metastases can be performed safely with acceptable mortality and morbidity rates, and can help to extend survival, if the DFI between the first and second hepatectomy is longer than 1 year.
authors.affiliation: Department of Surgery, Ogaki Municipal Hospital, Ogaki, Japan.
authors.forename: Gen
authors.initials: G
authors.lastname: Sugawara
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Isogai
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kaneoka
authors.forename: Masahiko
authors.initials: M
authors.lastname: Suzuki
authors.forename: Akihiro
authors.initials: A
authors.lastname: Yamaguchi
mesh_terms: D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D011379:Prognosis; D012086:Reoperation; D015996:Survival Rate; D016896:Treatment Outcome