title: Repeat Hepatectomy for Recurrent Colorectal Liver Metastases: Is it Worth the Challenge?
abstract: BACKGROUND
  Repeat hepatectomy (RH) is considered a valuable option for management of recurrent colorectal liver metastases (R-CLM). Here, the outcome of RH for R-CLM was compared to that of patients who underwent single hepatectomy (SH) after subdividing the later according to re-recurrence status.
  
  
  METHODS
  Between 2001 and 2013, patients who received hepatectomy for CLM and R-CLM were included in study. Patients with non-resectable R-CLM were excluded.
  
  
  RESULTS
  One hundred sixteen patients were included: 86 patients in SH group and 30 patients in RH group. Repeat hepatectomy group had more synchronous CLM (76.7 versus 50 %, p = 0.011). From the 86 patients who underwent SH, 69 patients did not have R-CLM. Survival analysis was done from the time of first hepatectomy for the no R-CLM group and the time of RH for the RH group. The 3- and 5-year survival rates for the no R-CLM group were 66.4 and 48.8%, respectively, and for the RH group were 56 and 44.8% respectively (p = 0.841). Multivariate analysis showed that larger size of R-CLM is an independent risk factor for survival after RH.
  
  
  CONCLUSIONS
  Repeat hepatectomy for R-CLM shows a comparable OS to non-recurrent CLM after single hepatectomy, despite the RH group had higher incidence of synchronous CLM.
authors.affiliation: Division of General Surgery and Transplantation, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy.|Gastroenterology Surgical Center, Mansoura University, Mansoura, Egypt.
authors.forename: Mahmoud Abdelwahab
authors.identifier: http://orcid.org/0000-0001-7958-4202
authors.initials: MA
authors.lastname: Ali
authors.affiliation: Division of General Surgery and Transplantation, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy. stefano.disandro@ospedaleniguarda.it.|Experimental Medicine, University of Pavia, Pavia, Italy. stefano.disandro@ospedaleniguarda.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Di Sandro
authors.affiliation: Division of General Surgery and Transplantation, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Lauterio
authors.affiliation: Division of General Surgery and Transplantation, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Concone
authors.affiliation: Division of General Surgery and Transplantation, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy.
authors.forename: Iacopo
authors.initials: I
authors.lastname: Mangoni
authors.affiliation: Division of General Surgery and Transplantation, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Ferla
authors.affiliation: Division of General Surgery and Transplantation, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Rotiroti
authors.affiliation: Division of General Surgery and Transplantation, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Cusumano
authors.affiliation: Division of General Surgery and Transplantation, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Giacomoni
authors.affiliation: Division of General Surgery and Transplantation, Ospedale Niguarda Ca' Granda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy.
authors.forename: Luciano
authors.initials: L
authors.lastname: De Carlis
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000601:surgery*; D012086:Reoperation; D016019:Survival Analysis; D015996:Survival Rate
keywords: Colorectal metastases; Liver resection; Liver tumor