Repeat hepatectomy is independently associated with favorable long-term outcome in patients with colorectal liver metastases.
Up to three-quarters of patients undergoing liver resection for colorectal liver metastases (CRLM) develop intrahepatic recurrence. Repeat hepatic resection appears to provide the optimal chance of cure for these patients. The aim of this study was to analyze short- and long-term outcomes following index and repeat hepatectomy for CRLM. Clinicopathological data were obtained from a prospectively maintained database. Perioperative variables and outcomes were compared using the Chi-squared test. Variables associated with long-term survival following index and second hepatectomy were identified by Cox regression analyses. Over the study period, 488 patients underwent hepatic resection for CRLM, with 71 patients undergoing repeat hepatectomy. There was no significant difference in rates of morbidity (P = 0.135), major morbidity (P = 0.638), or mortality (P = 0.623) when index and second hepatectomy were compared. Performance of repeat hepatectomy was independently associated with increased overall and cancer-specific survival following index hepatectomy. Short disease-free interval between index and second hepatectomy, number of liver metastases >1, and resection of extrahepatic disease were independently associated with shortened survival following repeat resection. Repeat hepatectomy for recurrent CRLM offers short-term outcomes equivalent to those of patients undergoing index hepatectomy, while being independently associated with improved long-term patient survival.
['Neal|Christopher P|CP|', 'Nana|Gael R|GR|', 'Jones|Michael|M|0000-0002-7193-2695', 'Cairns|Vaux|V|', 'Ngu|Wee|W|', 'Isherwood|John|J|', 'Dennison|Ashley R|AR|', 'Garcea|Giuseppe|G|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D015179:Colorectal Neoplasms D005260:Female D006498:Hepatectomy D006801:Humans D008113:Liver Neoplasms D008297:Male D008875:Middle Aged D009364:Neoplasm Recurrence, Local D011379:Prognosis D012086:Reoperation D016019:Survival Analysis D016896:Treatment Outcome
Colorectal cancer metastasectomy prognosis