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Repeat hepatectomy for colorectal liver metastases: A worthwhile operation?
A Muratore1, R Polastri, H Bouzari
11st Department of Surgery, Ospedale Mauriziano "Umberto I" Torino, Italy. andreamurat@hotmail.com
Journal of Surgical Oncology
|February 27, 2001
Summary
Repeat liver resection for colorectal metastases offers survival rates comparable to initial surgery. This approach is viable even with extrahepatic disease, demonstrating similar risks and benefits for long-term patient outcomes.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Gastrointestinal Oncology
Background:
- Colorectal cancer liver metastases frequently recur after initial resection.
- 10-20% of patients experience resectable hepatic recurrence post-curative resection.
- Assessing repeat hepatectomy's risk-benefit ratio is crucial.
Purpose of the Study:
- Evaluate the risk-benefit ratio of repeat liver resection.
- Compare outcomes to first hepatectomy.
- Identify prognostic factors for survival after repeat resection.
Main Methods:
- Retrospective analysis of 152 patients with colorectal liver metastases.
- 32 repeat hepatectomies performed on 29 patients.
- Analysis of in-hospital mortality, morbidity, and survival rates.
Main Results:
- In-hospital mortality was 3.5%, with lower morbidity than first hepatectomy.
- 3-year actuarial survival was 35.1%.
- Number of metastases and CEA levels were significant prognostic factors; synchronous extrahepatic disease resection did not lower survival.
Conclusions:
- Repeat liver resection provides long-term survival similar to first hepatectomy.
- Mortality and morbidity are comparable between first and repeat resections.
- Resectable extrahepatic disease should not preclude synchronous hepatectomy.