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Surgical and oncologic outcomes following repeat hepatic resection of colorectal liver metastasis: Who benefits?
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Surgical and oncologic outcomes following repeat hepatic resection of colorectal liver metastasis: Who benefits?
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Journal Article
Surgical and oncologic outcomes following repeat hepatic resection of colorectal liver metastasis: Who benefits?
2021
Overview
Resected colorectal liver metastases (CRLM) frequently recur intrahepatically. Selection criteria for repeat hepatectomy of recurrent CRLM are ill-defined.
We performed an institutional review of patients with recurrent CRLM undergoing repeat hepatectomy from 2003 to 19. Post-recurrence overall (rOS) and recurrence-free survival (RFS) were analyzed with Cox proportional hazards modeling.
n = 147 experienced recurrent CRLM; 11% (n = 38) received repeat hepatectomy of which there was one Clavien-Dindo IIIa complication. Median rOS was 41 months; median RFS was 9 months. Improved rOS and RFS were independently associated with additional post-operative chemotherapy after repeat hepatectomy (HR 0.35 and 0.34, respectively); poor rOS with recurrent CRLM >3 cm (HR 4.4) and <12 months from first hepatectomy to recurrence (HR 4.8); poor RFS with ≥3 recurrence liver metastases (HR 2.8) (All P < 0.05).
Repeat hepatectomy for recurrent CRLM can be performed safely. Worse survival following repeat hepatectomy is independently associated with >3 cm and ≥3 liver lesions at recurrence, and <12 months to recurrence. Additional post-operative chemotherapy after repeat hepatectomy is associated with improved outcomes.
•Repeat hepatectomy for recurrent CRLM can be performed with low morbidity.•Post repeat resection chemotherapy should be considered to lower risk of recurrence.•Poor outcomes after repeat hepatectomy with >3 cm or ≥3 liver lesions at recurrence.•Poor outcomes after repeat hepatectomy with <12mos from 1st resection to recurrence.
Publisher
Elsevier Inc,Elsevier Limited
