Repeat hepatectomy for liver metastases from colorectal primary cancer: a review of the literature.
BACKGROUND
After hepatectomy for metastases from colorectal cancer (CRC), approximately 50% to 70% of patients develop recurrent hepatic metastases. This recurrence is limited to the liver in about one-third of cases. The purpose of this study is to report a comprehensive review of the literature concerning the results of repeat hepatectomy for recurrent liver metastases from CRC.


METHODS
An electronic literature search was conducted to identify all medical articles published concerning repeat hepatectomy for liver metastases of colorectal origin during the period January 1990 to December 2010.


RESULTS
After a second hepatectomy, the mean mortality was 1.4% and the mean morbidity rate was 21.3%. The 5-year survival ranged from 16% to 55%. After a third or fourth hepatectomy, the mean mortality rate was 0% and the mean morbidity rate was 24.5%. After a third hepatectomy, the 5-year survival ranged from 23.8% to 37.9%. After a fourth hepatectomy, the 5-year survival was 9.3% to 36%.


CONCLUSIONS
Repeat hepatectomy seems justified, since it may result in prolonged survival with acceptable rates of morbidity and mortality, results similar to those seen after initial hepatectomy.
Pôle des pathologies digestives, hépatiques et de la transplantation, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, université de Strasbourg, avenue Molière, 67098 Strasbourg, France.
P
P
Lopez
E
E
Marzano
T
T
Piardi
P
P
Pessaux
D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation; D015996:Survival Rate; D016896:Treatment Outcome