[Repeat liver resection in colorectal liver metastases]

For patients with recurrent operable liver metastases from colorectal cancer operative resection is the only chance of getting rid of their tumorous disease for a longer time. As there are not therapeutic alternatives more and more authors are reporting on repeated resections of liver metastases. From 1986 to 1994 we performed 12 recurrent liver resections with curative intent in 8 patients suffering from liver metastases of colorectal cancer: 4 synchronous and 4 metachronous metastases were removed, the primary procedure being anatomic hemihepatectomy in 5 cases and segmentectomy or bisegmentectomy in 3 cases. The mean time interval between the first and the second resections was 14 (4-23) months. Two patients underwent 4 consecutive liver resections because of recurrent metastases. In these cases the interval between the second, third and fourth procedures was 10 months. The postoperative complication rate was 16% and not a single patient died in hospital. Three patients died an average of 28 (9-54) months after the last liver resection, and the other 5 patients are still alive after an average of 14 (4-28) months: 3 are free of tumor and 2 have recurrent metastases in the liver. Compared with untreated or only locally treated cases, patients in whom operative risk is low can achieve prolonged survival times after resections of colorectal metastases to the liver.