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Ann Surg. 2002 Jun;235(6):863-71.

Second liver resections are safe and effective treatment for recurrent hepatic metastases from colorectal cancer: a bi-institutional analysis.

Author information

1
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.

Abstract

OBJECTIVE:

To determine the value of repeat liver resection for recurrent colorectal metastases to the liver.

SUMMARY BACKGROUND DATA:

Liver resection represents the best and a potentially curative treatment for metastatic colorectal cancer to the liver. After resection, however, most patients develop recurrent disease, often isolated to the liver.

METHODS:

This study reports the combined experience of repeat liver resection for recurrent liver metastases at an American and a European surgical oncology center. Patients were identified from prospective databases and records were retrospectively reviewed. A total of 126 patients (American n = 96, 1986-2001; European n = 30, 1985-1999) underwent repeat liver resection. Patient characteristics were similar in the two institutions. Median follow-up from first liver resection was 88 and 105 months, respectively.

RESULTS:

Operations performed included 90 minor resections and 36 resections of a lobe or more. The 1-, 3-, and 5-year survival rates were 86%, 51%, and 34%. There were 19 actual 5-year survivors to date. By multivariate regression analysis (proportional hazard model), more than one lesion and tumor size larger than 5 cm were independent prognostic indicators of reduced survival. The interval between the first and second liver resection was not predictive of outcome.

CONCLUSIONS:

Repeat liver resection for colorectal liver metastases is safe. Patients with a low tumor load are the best candidates for a repeat resection. In well-selected patients, further resection of the liver can provide prolonged survival after recurrence of colorectal liver metastases.

PMID:
12035044
PMCID:
PMC1422517
DOI:
10.1097/00000658-200206000-00015
[Indexed for MEDLINE]
Free PMC Article

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