Abstract
Background. Liver resection is currently accepted as the only potential cure for patients with
metastases of colorectal tumors in the liver. However, cancer will recur in more than
70% of patients. Methods. In the 7 years to December 1997, 60 patients underwent liver resections for colorectal
metastases at our institute. Of these, 20 patients had repeated surgical resections
for recurrent disease of the liver and other organs. Another 2 patients had undergone
previous hepatectomy elsewhere. The clinical data for these patients were reviewed.
Results. The median interval between the 2 resections was 16 months. Eighteen hepatectomies,
6 lung resections, and 1 pancreatoduodenectomy were performed in 22 patients. Operative
mortality and complication rates were 0% and 18%, respectively. At a median follow-up
of 25 months after repeated resection, the survival rate in these patients was 73%
at 2 years (12 of 16 evaluable patients are surviving) and 22% at 5 years (2 of 10
evaluable patients are surviving); the median survival time was 44 months. Conclusions. Repeated resections for recurrent colorectal metastases yield comparable results
to first liver resections in operative mortality and morbidity rates, survival time,
and pattern of recurrence. Although the number of patients surviving more than 5 years
is still limited, the absence of other proven treatments supports the concept of an
aggressive reresectional approach for these patients. (Surgery 2000;127:528–35.)
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Article info
Publication history
Accepted:
November 28,
1999
Footnotes
*Reprint requests: Seiji Kawasaki, MD, Professor & Surgeon-in-Chief, First Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto 390, Japan.
**Surgery 2000;127:528–35
Identification
Copyright
© 2000 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
