title: Repeat reduction surgery after an initial hepatectomy for patients with colorectal cancer.
abstract: A hepatectomy is the only treatment offering long-term survival in patients with colorectal liver metastases. However, 70-80% of the patients with a complete resection develop recurrent disease after an initial hepatectomy. Sixty-one patients who underwent metastases from colorectal carcinoma with a curative hepatectomy were entered into this study. Recurrence after hepatectomy was observed in 41 patients (67.2%). We reviewed the outcome of these 41 patients. Repeat reduction surgery was performed on 16 out of 41 patients (39.0%). According to a multivariate analysis, repeat reduction surgery and tumor size were found to be independent prognostic factors for the survival rate (p=0.007, p=0.018). Furthermore, in the group that underwent repeat reduction surgery, the rate of positive lymph nodes was significantly lower in the primary lesions, and the disease-free interval (DFI) was also significantly longer than in the group that did not undergo repeat reduction surgery (p=0.023, p=0.045), respectively. Repeat reduction surgery was found to be the most important prognostic factor. Patients with a longer DFI and with negative lymph node findings at the primary site may therefore be considered to be good candidates for repeat reduction surgery.
authors.affiliation: Second Department of Surgery, School of Medicine, Wakayama Medical University, Wakayama 641-8510, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Matsuda
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Hotta
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Uchiyama
authors.forename: Masaji
authors.initials: M
authors.lastname: Tani
authors.forename: Katsunari
authors.initials: K
authors.lastname: Takifuji
authors.forename: Shozo
authors.initials: S
authors.lastname: Yokoyama
authors.forename: Takashi
authors.initials: T
authors.lastname: Higashiguchi
authors.forename: Toshiji
authors.initials: T
authors.lastname: Tominaga
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Oku
authors.forename: Toru
authors.initials: T
authors.lastname: Nasu
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yamaue
mesh_terms: D000368:Aged; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary / Q000601:surgery*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D009367:Neoplasm Staging; D011379:Prognosis; D012086:Reoperation; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome