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Repeat Hepatectomy for Recurrent Colorectal Liver Metastases: Is it Worth the Challenge?

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Introduction

Repeat hepatectomy (RH) is considered a valuable option for management of recurrent colorectal liver metastases (R-CLM). Here, the outcome of RH for R-CLM was compared to that of patients who underwent single hepatectomy (SH) after subdividing the later according to re-recurrence status.

Methods

Between 2001 and 2013, patients who received hepatectomy for CLM and R-CLM were included in study. Patients with non-resectable R-CLM were excluded.

Results

One hundred sixteen patients were included: 86 patients in SH group and 30 patients in RH group. Repeat hepatectomy group had more synchronous CLM (76.7 versus 50 %, p = 0.011). From the 86 patients who underwent SH, 69 patients did not have R-CLM. Survival analysis was done from the time of first hepatectomy for the no R-CLM group and the time of RH for the RH group. The 3- and 5-year survival rates for the no R-CLM group were 66.4 and 48.8%, respectively, and for the RH group were 56 and 44.8% respectively (p = 0.841). Multivariate analysis showed that larger size of R-CLM is an independent risk factor for survival after RH.

Conclusion

Repeat hepatectomy for R-CLM shows a comparable OS to non-recurrent CLM after single hepatectomy, despite the RH group had higher incidence of synchronous CLM.

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Abbreviations

CLM:

Colorectal liver metastases

RH:

Repeat hepatectomy

R-CLM:

Recurrent colorectal liver metastasis

SH:

Single hepatectomy

RFA:

Radiofrequency ablation

CEUS:

Contrast enhanced ultrasonography

CT:

Computed tomography

MRI:

Magnetic resonance imaging

CEA:

Carcino-embryonic antigen

OS:

Overall survival

PFS:

Progression-free survival

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Conflict of interest

No conflict of interest to disclose.

Author information

Authors and Affiliations

  1. Division of General Surgery and Transplantation, Ospedale Niguarda Ca’ Granda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy

    Mahmoud Abdelwahab Ali, Stefano Di Sandro, Andrea Lauterio, Giacomo Concone, Iacopo Mangoni, Fabio Ferla, Valeria Rotiroti, Caterina Cusumano, Alessandro Giacomoni & Luciano De Carlis

  2. Experimental Medicine, University of Pavia, Pavia, Italy

    Stefano Di Sandro

  3. Gastroenterology Surgical Center, Mansoura University, Mansoura, Egypt

    Mahmoud Abdelwahab Ali

Authors
  1. Mahmoud Abdelwahab Ali
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  2. Stefano Di Sandro
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  3. Andrea Lauterio
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  4. Giacomo Concone
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  5. Iacopo Mangoni
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  8. Caterina Cusumano
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  9. Alessandro Giacomoni
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  10. Luciano De Carlis
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Correspondence to Stefano Di Sandro.

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Ali, M.A., Di Sandro, S., Lauterio, A. et al. Repeat Hepatectomy for Recurrent Colorectal Liver Metastases: Is it Worth the Challenge?. J Gastrointest Surg 19, 2192–2198 (2015). https://doi.org/10.1007/s11605-015-2939-4

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  • DOI: https://doi.org/10.1007/s11605-015-2939-4

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