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A Second Liver Resection Due to Recurrent Colorectal Liver Metastases
Antonio Sa Cunha, MD;
Christophe Laurent, MD;
Alexandre Rault, MD;
Philippe Couderc, MD;
Eric Rullier, MD;
Jean Saric, MD
Arch Surg. 2007;142(12):1144-1149.
Background Repeat liver resection because of recurrent colorectal liver metastases can provide survival benefit with a low rate of complications.
Design Retrospective study.
Participants Forty patients who underwent a second hepatectomy because of liver metastases from colorectal cancer.
Main Outcome Measures 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.
Author Affiliations: Department of Digestive Surgery, University Hospital of Bordeaux, Bordeaux, France.
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Timothy M. Pawlik
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