Feasibility of "Watch-and-Wait" Management before Repeat Hepatectomy for Colorectal Liver Metastases
Related Experiment Video
Updated: Sep 21, 2026
Application of Hemostatic Devices in Laparoscopic Hepatectomy
Published on: April 19, 2022
Yoji Kishi1, Satoshi Nara2, Minoru Esaki2
1Hepatobiliary and Pancreatic Surgery Division, National Cancer Center Hospital, Tokyo, Japan, yokishi@ncc.go.jp.
Background:
Whether repeat hepatectomy for colorectal liver metastases should be performed after chemotherapy or observation is unclear.
Methods:
We selected patients with resectable hepatic recurrence after their first hepatectomies performed between 2000 and 2015. They were classified according to the further treatment: Group A, prompt repeat hepatectomy; Group B, observation; and Group C, ≤6 months of chemotherapy. In Group B/C, patients who later underwent hepatectomy and those who did not due to disease progression were classified as B1/C1 and B2/C2, respectively. Predictors of B2/C2 were evaluated.
Results:
Groups A, B, and C consisted of 81, 36, and 17 patients, respectively. Recurrence-free interval was longer in Group A (median months; Group A, 10.3; Group B, 5.7; Group C, 3.5; p < 0.01). Group B1/C1 and B2/C2 included 34 and 19 patients, respectively. Five-year survival after recurrence of Group B1/C1 was 56%, which was comparable with Group A (56%, p = 0.77) and better than Group B2/C2 (0%, p < 0.01). Multivariate analysis showed synchronous colorectal liver metastases (OR 7.23) and recurrent hepatic tumor number (OR 4.04) were predictors of tumor progression.
Conclusion:
Selecting patients optimally either for prompt or delayed repeat hepatectomy following chemotherapy or observation is a feasible strategy.
