Repeated hepatectomy for colorectal metastasis

Between January 1981 and December 1995, 12 patients, who previously underwent hepatic resection for colorectal metastases, were selected for a second liver resection for isolated liver recurrence. Mean interval between first and second resection was 16 months. Eight patients had solitary and 4 multiple metastasis. Two major hepatectomies and 11 wedge resections were performed. Mean follow-up was 37 months. No mortality and 33% morbidity was observed. Three and 5-year actuarial survival rates were 71% and 42%, while disease-free survival was 30%. No patient, primary tumour, or metastases' characteristics were significantly associated to survival. Surgical resection is the only therapy that could offer reasonable chance of long term survival and, in selected case, of cure. A careful patients' selection as well as an accurate surgical technique are essential to reduce post operative mortality and morbidity.