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Repeat hepatectomy for colorectal liver metastases
R Adam1, H Bismuth, D Castaing
1Liver Transplant Unit, Hôpital Paul Brousse, Université Paris Sud, Villejuif, France.
Annals of Surgery
|January 1, 1997
Summary
Repeat hepatectomies for colorectal cancer liver metastases offer long-term survival comparable to initial surgeries. Key factors for success include the curative intent of the repeat surgery and a time interval exceeding one year between procedures.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Colorectal Cancer Management
Background:
- Advancements in hepatic resection techniques enable repeat surgeries for colorectal cancer liver metastases.
- Repeat hepatectomies may involve increased risks, necessitating evaluation of long-term benefits.
Purpose of the Study:
- To assess long-term outcomes of repeat hepatectomies for recurrent colorectal cancer liver metastases.
- To identify predictors of survival following repeat liver resections.
Main Methods:
- Retrospective analysis of 83 repeat hepatectomies (second, third, or fourth) in 64 patients with colorectal liver metastases.
- Evaluation of intraoperative/postoperative outcomes, survival rates, and prognostic factors.
Main Results:
- No mortality associated with repeat hepatectomies; bleeding, morbidity, and hospital stay were comparable to first resections.
- Five-year survival rates after second hepatectomy were 41% overall and 26% disease-free.
- Curative intent of the second hepatectomy and an interval >1 year between procedures were independent predictors of survival.
Conclusions:
- Repeat hepatectomies achieve long-term survival comparable to initial resections with acceptable safety.
- Potentially curative repeat hepatectomies, sometimes requiring combined extrahepatic surgery, are valuable for managing recurrent colorectal cancer liver metastases.