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Repeat Resection for Advanced Colorectal Liver Metastases—Does it have the Potential for Cure?

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Abstract

Background

Although surgical resection is the only potential treatment for patients with colorectal liver metastases (CLM), the actual cure is rare in patients with advanced CLM. Repeat resection (RR) is the most effective treatment in patients with recurrence; however, whether patients with initially advanced CLM achieve cure throughout RR or experience repeated recurrence even after RR remains unclear. In this study, we analyzed whether patients with advanced CLM achieve cure after RR.

Methods

Consecutive patients who underwent initial hepatectomy with curative intent for CLM from January 1999 to August 2007 were included. Patients who were alive at 10 years from the initial hepatectomy without any evidence of recurrence were defined as cured. Cure rates were compared between patients with Fong’s clinical risk score (CRS) of ≥ 3 and those with CRS of ≤ 2.

Results

A total of 257 patients were included and followed up. Among them, 93 (36.2%) patients achieved actual cure postoperatively. The cure rate of patients with a CRS of ≥ 3 was 32.4% (33/102), which was not different from that of patients with a CRS of ≤ 2 (38.7% [60/155]; p = 0.299), although former patients had higher recurrence rate after the initial hepatectomy than latter ones (85.3% vs. 72.3%; p = 0.014). The cure rates after the initial, second, and third resections were 23.0% (59/257), 30.0% (24/80), and 22.5% (7/31), respectively. In multivariate analysis, RR was determined as an independent favorable factor of achieving cure.

Conclusions

RR had a potential to cure patients with advanced CLM, and one-third of them achieved cure.

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Authors and Affiliations

  1. Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, Japan

    Yoshinori Takeda, Yoshihiro Mise, Hiromichi Ito, Yoshihiro Ono, Takafumi Sato, Yosuke Inoue, Yu Takahashi & Akio Saiura

  2. Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

    Yoshinori Takeda, Yoshihiro Mise & Akio Saiura

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  1. Yoshinori Takeda
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  2. Yoshihiro Mise
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  3. Hiromichi Ito
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Correspondence to Akio Saiura.

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Conflict of interest

The authors declare that they have no conflict of interest. The institutional review board waived the need for informed consent to be obtained from the patients for the use of their medical records, imaging records, or pathology records in this retrospective study. This study was performed in-line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Cancer Institute Hospital Review Board (2017–1152).

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Takeda, Y., Mise, Y., Ito, H. et al. Repeat Resection for Advanced Colorectal Liver Metastases—Does it have the Potential for Cure?. World J Surg 46, 2253–2261 (2022). https://doi.org/10.1007/s00268-022-06616-8

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  • DOI: https://doi.org/10.1007/s00268-022-06616-8

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