title: Management of intrahepatic recurrence after curative treatment of colorectal liver metastases.
abstract: BACKGROUND
  Management of intrahepatic recurrence after complete surgical treatment for colorectal liver metastases is not well defined. The aim of this study was to analyse the survival results of patients who had repeat liver resection for intrahepatic recurrence and to evaluate prognostic indicators for survival.
  
  
  METHODS
  Between 1991 and 2005, 55 patients had repeat liver resection for isolated intrahepatic recurrence. The long-term survival results were assessed. Univariable and multivariable analyses were used to identify prognostic indicators for survival after repeat hepatectomy.
  
  
  RESULTS
  The median survival was 53 (range 2-97) months and the 5-year survival rate was 49 per cent. In univariable analysis, size of largest initial liver metastasis, margin of initial liver surgery, carcinoembryonic antigen (CEA) level before and after initial liver surgery, liver disease-free survival, margin of repeat liver surgery, operation type of repeat surgery and CEA level before and after repeat surgery were significant prognostic factors. In multivariable analysis, largest initial liver metastasis 4 cm or less and CEA level 5 ng/ml or less after repeat liver surgery were independently associated with improved survival.
  
  
  CONCLUSIONS
  Repeat hepatectomy can achieve an acceptable survival in selected patients with isolated intrahepatic recurrence.
authors.affiliation: Department of Surgery, University of New South Wales, St George Hospital, Sydney, New South Wales, Australia.
authors.forename: T D
authors.initials: TD
authors.lastname: Yan
authors.forename: K Q
authors.initials: KQ
authors.lastname: Lian
authors.forename: D
authors.initials: D
authors.lastname: Chang
authors.forename: D L
authors.initials: DL
authors.lastname: Morris
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D012189:Retrospective Studies; D016019:Survival Analysis