Repeat resections for recurrent colorectal liver metastases

  • Bernard Nordlinger
  • J.-C. Vaillant
Part of the Cancer Treatment and Research book series (CTAR, volume 69)

Abstract

The 5-year survival rate after surgical resection of colorectal liver metastases is close to 25% and ranges from 16% to 45% [1–13]. On the other hand, few patients with unresected colorectal liver metastases survive 5 years [14–16]. Unfortunately, tumors recur in 60–70% of patients during the years or even months following liver resections [6,8,11,17–22]. About half of these recurrences are located in the liver [8,23] but most of them are diffuse and unresectable. Ten to 55% of the recurrences are isolated in the liver without extrahepatic involvement [2,4,6,8,9,11,17–26]. However, a small percent of them are theoretically resectable according to their size, location, and relations with vessels. Two questions should be answered to determine the validity of repeat resections of recurrent liver metastases:
  1. 1.

    Is their operative risk higher than in primary liver resections?

     
  2. 2.

    What are the long-term results? Most published series are retrospective and do not exceed 10–15 patients. Recently, a French multicentric study [23] collected data from more than 100 patients who had undergone repeat liver resections, 15 of them having received three liver resections.

     

Keywords

Catheter Oncol Gall Bismuth Triad 

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References

  1. 1.
    Adson MA, Van Heerden JA, Adson MH, Wagner JS, Ilstrup DM. 1984. Resection of hepatic metastases from colorectal cancer. Arch Surg 119:647–651.PubMedCrossRefGoogle Scholar
  2. 2.
    Butler J, Attiyeh FF, Daly JM. 1986. Hepatic resection for metastases of the colon and rectum. Surg Gynecol Obstet 162:109–113.PubMedGoogle Scholar
  3. 3.
    Cobourn CS, Makowka L, Langer B, Taylor BR, Falk RE. 1987. Examination of patient selection and outcome for hepatic resection for metastatic disease. Surg Gynecol Obstet 165:239–246.PubMedGoogle Scholar
  4. 4.
    Doci R, Gennari L, Bignami P, Montalto F, Morabito A, Bozzetti F. 1991. One hundred patients with hepatic metastases from colorectal cancer treated by resection: Analysis of prognostic determinants. Br J Surg 78:797–801.PubMedCrossRefGoogle Scholar
  5. 5.
    Ekberg H, Tranberg KG, Andersson R, Lundstedt C, Hägerstrand I, Ranstam J, et al. 1986. Determinants of survival in liver resection for colorectal secondaries. Br J Surg 73:727–731.PubMedCrossRefGoogle Scholar
  6. 6.
    Fortner JG, Silva JS, Golbey RB, Cox EB, MacLean J. 1984. Multivariate analysis of a personal series of 247 consecutive patients with liver metastases from colorectal cancer. 1-Treatment by hepatic resection. Ann Surg 199:306–316.PubMedCrossRefGoogle Scholar
  7. 7.
    Holm A, Bradley E, Aldrete JS. 1990. Hepatic resection of metastasis from colorectal carcinoma — Morbidity, mortality, and pattern of recurrence. Ann Surg 209:428–434.CrossRefGoogle Scholar
  8. 8.
    Hughes KS, Simon R, Songhorabodi S. 1986. Resection of the liver for colorectal carcinoma metastases: A multi-institutional study of patterns of recurrence. Surgery 100:278–284.PubMedGoogle Scholar
  9. 9.
    Iwatsuki S, Esquivel CO, Gordon RD, Starzl TE. 1986. Liver resection for metastatic colorectal cancer. Surgery 100:804–810.PubMedGoogle Scholar
  10. 10.
    Lise M, Pian PPD, Nitti D, Pilati PL, Prevaldi C. 1990. Colorectal metastases to the liver: Present status and management. Dis Colon Rectum 33:688–694.PubMedCrossRefGoogle Scholar
  11. 11.
    Nordlinger B, Quilichini MA, Parc R, Hannoun L, Delva E, Huguet C. 1987. Hepatic resection for colorectal liver metastases — Influence on survival of preoperative factors and surgery for recurrences in 80 patients. Ann Surg 205:256–263.PubMedCrossRefGoogle Scholar
  12. 12.
    Sesto ME, Vogt DP, Hermann RE. 1987. Hepatic resection in 128 patients: A 24-year experience. Surgery 102:846–851.PubMedGoogle Scholar
  13. 13.
    Scheele J, Stangl R, Altendorf-Hofmann A, Gall FP. 1991. Indicators of prognosis after hepatic resection for colorectal secondaries. Surgery 110:13–29.PubMedGoogle Scholar
  14. 14.
    Fujimoto S, Miyasaki M, Higuchi M, Okui K. 1984. Long term survivors of colorectal cancer with unresectable hepatic metastases. Dis Colon Rectum 28:588–591.CrossRefGoogle Scholar
  15. 15.
    Registry of Hepatic Metastases. 1988. Resection of the liver for colorectal carcinoma metastases: A multi-institutional study of indications for resection. Surgery 103:278–288.Google Scholar
  16. 16.
    Scheele J, Stangl R, Altendorf-Hofmann A. 1990. Hepatic metastases from colorectal carcinoma: Impact of surgical resection on the natural history. Br J Surg 77:1241–1246.PubMedCrossRefGoogle Scholar
  17. 17.
    Adson MA. 1987. Resection of liver metastases — When is it worthwhile? World J Surg 11:511–520.PubMedCrossRefGoogle Scholar
  18. 18.
    August DA, Sugarbaker PH, Ottow RT, Gianola FJ, Schneider PD. 1985. Hepatic resection of colorectal metastases — Influence of clinical factors and adjuvant intraperitoneal 5-Fluorouracil via Tenckhoff catheter on survival. Ann Surg 201:210–218.PubMedCrossRefGoogle Scholar
  19. 19.
    Bozzetti F, Bignami P, Morabito A, Doci R, Gennari L. 1987. Patterns of failure following surgical resection of colorectal cancer liver metastases — Rationale for a multimodal approach. Ann Surg 205:264–270.PubMedCrossRefGoogle Scholar
  20. 20.
    Ekberg H, Tranberg KG, Andersson R, Lundstedt C, Hägerstrand I, Ranstam J, et al. 1987. Patterns of recurrence in liver resection for colorectal secondaries. World J Surg 11:541–547.PubMedCrossRefGoogle Scholar
  21. 21.
    Fortner JG. 1988. Recurrence of colorectal cancer after hepatic resection. Am J Surg 155:378–382.PubMedCrossRefGoogle Scholar
  22. 22.
    Wagner JS, Adson MA, Van Heerden JA, Adson MH, Ilstrup DM. 1984. The natural history of hepatic metastases from colorectal cancer — A comparison with resective treatment. Ann Surg 199:502–508.PubMedCrossRefGoogle Scholar
  23. 23.
    Nordlinger B, Jaeck D, Guiguet M, Vaillant JC, Balladur P, Schaal JC. 1993. Résection chirurgicale des métastases hépatiques. Enquête de l’Association Française de Chirurgie. In: B Nordlinger, D Jaeck (eds): Résultats du Traitement Chirurgical des Métastases Hépatiques d’origine Colo-rectale. Paris: Springer Verlag, pp 141–159.Google Scholar
  24. 24.
    Bozzetti F, Bignami P, Montalto F, Doci R, Gennari L. 1992. Repeated hepatic resection for recurrent metastases from colorectal cancer. Br J Surg 79:146–148.PubMedCrossRefGoogle Scholar
  25. 25.
    Bradpiece HA, Benjamin IS, Halevy A, Blumgart LH. 1987. Major hepatic resection for colorectal liver metastases. Br J Surg 74:324–326.PubMedCrossRefGoogle Scholar
  26. 26.
    Gennari L, Doci R, Bozzetti F, Bignami P. 1986. Surgical treatment of hepatic metastases from colorectal cancer. Ann Surg 203:49–54.PubMedCrossRefGoogle Scholar
  27. 27.
    Dagradi AD, Mangiante GL, Marchiori LA, Nicoli NM. 1987. Repeated hepatic resection. Int Surg 72:87–92.PubMedGoogle Scholar
  28. 28.
    Stone MD, Cady B, Jenkins RL, McDermott WV, Steele GD. 1990. Surgical therapy for recurrent liver metastases from colorectal cancer. Arch Surg 125:718–722.PubMedCrossRefGoogle Scholar
  29. 29.
    Vogt P, Raab R, Ringe B, Pichlmayr R. 1991. Resection of synchronous liver metastases from colorectal cancer. World J Surg 15:62–67.PubMedCrossRefGoogle Scholar
  30. 30.
    Morrow CE, Grage TB, Sutherland DER, Najarian JS. 1982. Hepatic resection for secondary neoplasms. Surgery 92:610–614.PubMedGoogle Scholar
  31. 31.
    Petrelli NJ, Nambisan RN, Herrera L, Mittelman A. 1985. Hepatic resection for isolated metastasis from colorectal carcinoma. Am J Surg 149:205–209.PubMedCrossRefGoogle Scholar
  32. 32.
    Cady B, Stone MD. 1991. The role of surgical resection of liver metastases in colorectal carcinoma. Sem Oncol 18:399–406.Google Scholar
  33. 33.
    Lange JF, Leese T, Bismuth H. 1989. Repeat hepatectomy for recurrent malignant tumors of the liver. Surg Gynecol Obstet 169:119–126.PubMedGoogle Scholar
  34. 34.
    Gouillat C, Partensky C, Campos RD, Bérard P. 1991. Les résections hépatiques itératives après hépatectomie réglée pour métastases des cancers digestifs. Lyon Chir 87:376–378.Google Scholar
  35. 35.
    Clarke MP, Kane RA, Steele G, Hamilton ES, Ravikumar TS, Onik G, et al. 1989. Prospective comparison of preoperative imaging and intraoperative ultrasonography in the detection of liver tumors. Surgery 106:849–855.PubMedGoogle Scholar
  36. 36.
    Delva E, Camus Y, Nordlinger B, Hannoun L, Parc R, Deriaz H, et al. 1989. Vascular occlusions for liver resections. Ann Surg 209:211–218.PubMedCrossRefGoogle Scholar
  37. 37.
    Huguet C, Nordlinger B, Galopin JJ, Bloch P, Gallot D. 1978. Normothermic hepatic vascular exclusion for extensive hepatectomies. Surg Gynecol Obstet 147:689–693.PubMedGoogle Scholar
  38. 38.
    Huguet C, Bona S, Nordlinger B, Lagrange L, Harb J, Benard F. 1990. Repeat hepatic resection for primary and metastatic carcinoma of the liver. Surg Gynecol Obstet 171: 398–402.PubMedGoogle Scholar
  39. 39.
    Tomas de la Vega JE, Donahue EJ, Doolas A, Roseman DL, Straus A, Bonomi PD, et al. 1984. A ten year experience with hepatic resection. Surg Gynecol Obstet 159:223–228.PubMedGoogle Scholar
  40. 40.
    Attiyeh FF, Wichern WA. 1988. Hepatic resection for primary and metastatic tumors. Am J Surg 156:368–373.PubMedCrossRefGoogle Scholar
  41. 41.
    Brown DA, Pommier RF, Woltering EA, Fletcher WS. 1988. Nonanatomic hepatic resection for secondary hepatic tumors with special reference to hemostatic technique. Arch Surg 123:1063–1066.PubMedCrossRefGoogle Scholar
  42. 42.
    Minton JP, Hamilton WB, Sardi A, Nieroda C, Sickle-Santanello B, O’Dwyer PJ. 1989. Results of surgical excision of one to 13 hepatic metastases in 98 consecutive patients. Arch Surg 124:46–48.PubMedCrossRefGoogle Scholar
  43. 43.
    Vaillant JC, Karaitianos I, Nordlinger B, Hannoun L, Parc R. 1989. Successive curative resections for recurrent liver metastases from digestive tract origin. First International Gastro-Surgical Club Joint Meeting of Surgeons and Gastroenterologists. August 1 to September 2, 1989, Amsterdam, The Netherlands.Google Scholar
  44. 44.
    Griffith KD, Sugarbaker PH, Chang AE. 1990. Repeat hepatic resections for colorectal metastases. Surgery 107:101–104.PubMedGoogle Scholar
  45. 45.
    Joyeux H, Saint-Aubert B, Szawlowski AW, Astre C, Solassol C. 1987. Chirurgie carcino-logique pour des métastases hépatiques diffuses. Chirurgie 113:113–116.PubMedGoogle Scholar
  46. 46.
    Nakamura S, Yokoi Y, Suzuki S, Baba S, Muro H. 1992. Results of extensive surgery for liver metastases in colorectal carcinoma. Br J Surg 79:35–38.PubMedCrossRefGoogle Scholar
  47. 47.
    O’Grady JG, Poison RJ, Rolles K, Calne RY, Williams R. 1988. Liver transplantation for malignant disease — Results in 93 consecutive patients. Ann Surg 207:373–379.PubMedCrossRefGoogle Scholar
  48. 48.
    Egeli RA. 1991. Traitement des Métastases Hépatiques. MD Thesis, Universitéi de Genève.Google Scholar

Copyright information

© Springer Science+Business Media Dordrecht 1994

Authors and Affiliations

  • Bernard Nordlinger
  • J.-C. Vaillant

There are no affiliations available

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