Risk of recurrence does not decrease in patients undergoing the second and third resection of colorectal liver...

Repeat liver resection is a well-established treatment option for patients with recurrent colorectal liver metastases (CLM). However, the risk of recurrence following the second and third CLM resections was not assessed.

Data of patients undergoing first, second, and third CLM resection between 2005 and 2018 were obtained from a prospectively maintained database.

Of the 695 patients, 486, 159, and 50 underwent first, second, and third CLM resections, respectively. The changing risks of recurrence in patients undergoing first, second, and third CLM resection, and the cumulative recurrence curve after a given interval without recurrence in patients undergoing first and second CLM resection were relatively similar. Time to recurrence after the first CLM resection ≤12 months (HR 2.09, 95% CI 1.35-3.23, P = 0.001) and number of CLM (HR 1.07, 95% CI 1.02-1.12, P = 0.003) were significant risk factors for recurrence in patients undergoing second CLM resection.

Patients undergoing second and third CLM resection did not have a lower risk of recurrence than those undergoing first CLM resection. The surveillance strategy after the second and third CLM resections should be similar to that after the first CLM resection.