Postoperative complications following aggressive repeat hepatectomy for colorectal liver metastasis have adverse oncological outcomes.
OBJECTIVE
Repeat hepatectomy remains the only curative treatment for recurrent colorectal liver metastasis (CLM) after primary hepatectomy. However, the repeat resection rate is still low, and there is insufficient data on the outcomes after repeat hepatectomy. The aim of this study was to investigate the feasibility and prognostic benefit of aggressive repeat hepatectomy for recurrent CLM.


METHODS
Data were reviewed from 282 consecutive patients who underwent primary curative hepatectomy for CLM between January 1994 and March 2015. The short- and long-term outcomes were analyzed.


RESULTS
One hundred ninety-three patients (68 %) developed recurrence, and repeat hepatectomy was conducted in 62 patients. Overall, 62 s, 11 third, 4 fourth, and 1 fifth hepatectomies were performed. The postoperative morbidity and mortality rates were low (11.5 and 1.3 %, respectively). The overall survival rates at 3 and 5 years after primary hepatectomy for CLM in the repeat hepatectomy group were 79.5 and 57.4 %, respectively. A multivariate analysis indicated that postoperative complications were independently associated with overall survival after repeat hepatectomy.


CONCLUSIONS
Repeat hepatectomy for CLM is feasible, with acceptable rates of perioperative morbidity and mortality, and the potential for long-term survival. However, postoperative complications following aggressive repeat hepatectomy for CLM are associated with adverse oncological outcomes.
Department of Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho, 503-8502, Ogaki, Gifu, Japan. yasuyuki490225@yahoo.co.jp.
Yasuyuki
Y
Fukami
Department of Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho, 503-8502, Ogaki, Gifu, Japan.
Yuji
Y
Kaneoka
Department of Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho, 503-8502, Ogaki, Gifu, Japan.
Atsuyuki
A
Maeda
Department of Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho, 503-8502, Ogaki, Gifu, Japan.
Yuichi
Y
Takayama
Department of Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho, 503-8502, Ogaki, Gifu, Japan.
Shunsuke
S
Onoe
D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology*; D005240:Feasibility Studies; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects* / Q000379:methods* / Q000401:mortality; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D012086:Reoperation / Q000009:adverse effects*; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
Colorectal liver metastases; Hepatectomy; Postoperative complication; Recurrence; Repeat resection