A second liver resection due to recurrent colorectal liver metastases.
BACKGROUND
Repeat liver resection because of recurrent colorectal liver metastases can provide survival benefit with a low rate of complications.


METHODS
Retrospective study.


METHODS
Forty patients who underwent a second hepatectomy because of liver metastases from colorectal cancer.


METHODS
Short- and long-term results of a second hepatectomy and determination of prognostic factors.


RESULTS
The postoperative mortality rate was 2.5%. The postoperative morbidity rate was not significantly different after a second hepatectomy compared with single hepatectomy (42.5% and 27.5%, respectively; P = .10). Transfusion requirement and hospital stay were comparable for both a single and a second hepatectomy. Three- and 5-year overall survival rates were 55% and 31%, respectively. Disease-free survival rates at 3 and 5 years were, respectively, 49% and 27%. The interval between first and second hepatectomies and the presence of extrahepatic disease were independently related to survival (multivariate analysis).


CONCLUSIONS
A second liver resection because of recurrent liver metastases from colorectal cancer is safe and provides a survival benefit similar to that with single hepatectomy. Our analysis suggests that the benefit of treatment is limited in patients who undergo a second hepatectomy within 1 year of the first operation and in those with extrahepatic disease.
Sa Cunha
Antonio
A
Department of Digestive Surgery, University Hospital of Bordeaux, Ave de Magellan, Pessac 33604, Bordeaux, France.
Laurent
Christophe
C
Rault
Alexandre
A
Couderc
Philippe
P
Rullier
Eric
E
Saric
Jean
J
D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D011379:Prognosis; D012086:Reoperation; D012189:Retrospective Studies; D016019:Survival Analysis