Repeated procedures for colorectal liver metastases.
OBJECTIVE
After primary liver surgery a recurrence of colorectal liver metastases (CRLM) occurs in 45-80% of patients. Without the possibility of further surgical treatment, most of these patients die within 1 year. The aim of this study was to evaluate the long-term results of repeated liver procedures for recurrent CRLM.


METHODS
The authors operated on a total of 151 patients with CRLM from January 1, 2000 to November 1, 2005. Repeated procedures were performed on 24 patients in the interval 6-37 months after primary liver surgery. A total of 51 procedures were performed. Long-term results were compared with the group of patients (N = 127) where only one type of liver procedure was performed.


RESULTS
30-day postoperative mortality (N = 24) was zero. 83.3%, 64.8% and 34.3% of patients survived 1.2 and 3 years after the repeated procedures. Disease-free interval (DFI) was 32.1%, 5.3% and 0% for 1, 2 and 3 years. 30-day postoperative mortality (N = 127) was 0.8%. 76.6%, 51.9%, 31.9% survived 1, 2 and 3 years after the liver procedures (p < 0.08). DFI in this group of patients for 1, 2 and 3 years was 57.9%, 35.1% and 17.7% (p < 0.0001).


CONCLUSIONS
Repeated liver procedures are fully indicated. They significantly prolong the life of patients with CRLM recurrence.
Treska
Vladislav
V
Department of Surgery, University Hospital, Faculty of Medicine Pilsen, Czech Republic. treska@fnplzen.cz
Skalicky
Tomas
T
Liska
Vaclav
V
Ferda
Jiri
J
D000368:Aged; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008495:Medical Oncology / Q000379:methods; D008875:Middle Aged; D009362:Neoplasm Metastasis; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome