Repeat reduction surgery after an initial hepatectomy for patients with colorectal cancer

A hepatectomy is the only treatment offering long-term survival in patients with colorectal liver metastases. However, 70-80% of the patients with a complete resection develop recurrent disease after an initial hepatectomy. Sixty-one patients who underwent metastases from colorectal carcinoma with a curative hepatectomy were entered into this study. Recurrence after hepatectomy was observed in 41 patients (67.2%). We reviewed the outcome of these 41 patients. Repeat reduction surgery was performed on 16 out of 41 patients (39.0%). According to a multivariate analysis, repeat reduction surgery and tumor size were found to be independent prognostic factors for the survival rate (p=0.007, p=0.018). Furthermore, in the group that underwent repeat reduction surgery, the rate of positive lymph nodes was significantly lower in the primary lesions, and the disease-free interval (DFI) was also significantly longer than in the group that did not undergo repeat reduction surgery (p=0.023, p=0.045), respectively. Repeat reduction surgery was found to be the most important prognostic factor. Patients with a longer DFI and with negative lymph node findings at the primary site may therefore be considered to be good candidates for repeat reduction surgery.