Second Hepatectomy for Recurrent Colorectal Liver Metastasis: Analysis of Preoperative Prognostic Factors

Abstract

Second hepatectomy is beneficial for patients without any risk factors. Before second hepatectomy, chemotherapy should be considered for patients with any of these risk factors, especially with two or three factors, in the adjuvant or neoadjuvant setting to prolong survival. These results need to be confirmed and validated in another data set or future prospective trial according to the scoring scheme we outline.

Repeat Curative Intent Liver Surgery is Safe and Effective for Recurrent Colorectal Liver Metastasis: Results from an International Multi-institutional Analysis

“…Management of these patients can be challenging to the surgeon, and there has been a perception that the increased technical difficulties associated with repeat hepatectomy lead to increased morbidity and mortality. 46 48,49 Most of these series included fewer than 100 patients and were limited by their small sample size. The current study is important because it reports the largest multi-institutional experience with repeat CIS for recurrent colorectal liver metastasis.…”

Repeat hepatectomy for liver metastases from colorectal primary cancer: A review of the literature

“…After excluding articles involving fewer than 15 patients, and excluding duplicative publications by the same team, we were left with 28 articles with a total of 1744 patients for analysis (range 15-246 patients) ( Table 1). Only six studies included over 100 patients [11,12,20,22,28,35]. All these studies were reports of patient series without controls and classified as level 4 evidence.…”

Metastatic recurrence after complete resection of colorectal liver metastases: impact of surgery and chemotherapy on survival

“…The main sites of these SMR are the liver or the lung but in 30 % of patients multiple sites can be affected [9]. Previous studies have demonstrated that in selected patients re-resection of isolated hepatic [10–14] or pulmonal [15, 16] SMR might result not only in encouraging survival rates similar to those after resection of the first metastatic recurrence but also in higher quality of life compared to continued palliative Ctx [17]. In their single-center experience, Adam et al have even demonstrated a 5-year OS of 34 % after the third hepatectomy for recurrent liver metastases [18].…”