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Repeat hepatectomy is independently associated with favorable long-term outcome in patients with colorectal liver metastases

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posted on 25.04.2017, 10:59 by Christopher P. Neal, Gael R. Nana, Michael Jones, Vaux Cairns, Wee Ngu, John Isherwood, Ashley R. Dennison, Giuseppe Garcea
Up to three-quarters of patients undergoing liver resection for colorectal liver metastases (CRLM) develop intrahepatic recurrence. Repeat hepatic resection appears to provide the optimal chance of cure for these patients. The aim of this study was to analyze short- and long-term outcomes following index and repeat hepatectomy for CRLM. Clinicopathological data were obtained from a prospectively maintained database. Perioperative variables and outcomes were compared using the Chi-squared test. Variables associated with long-term survival following index and second hepatectomy were identified by Cox regression analyses. Over the study period, 488 patients underwent hepatic resection for CRLM, with 71 patients undergoing repeat hepatectomy. There was no significant difference in rates of morbidity (P = 0.135), major morbidity (P = 0.638), or mortality (P = 0.623) when index and second hepatectomy were compared. Performance of repeat hepatectomy was independently associated with increased overall and cancer-specific survival following index hepatectomy. Short disease-free interval between index and second hepatectomy, number of liver metastases >1, and resection of extrahepatic disease were independently associated with shortened survival following repeat resection. Repeat hepatectomy for recurrent CRLM offers short-term outcomes equivalent to those of patients undergoing index hepatectomy, while being independently associated with improved long-term patient survival.

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Citation

Cancer Medicine, 2017, 6 (2), pp. 331-338

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Cancer Studies and Molecular Medicine

Version

VoR (Version of Record)

Published in

Cancer Medicine

Publisher

Wiley Open Access

eissn

2045-7634

Acceptance date

27/07/2016

Copyright date

2017

Available date

25/04/2017

Publisher version

http://onlinelibrary.wiley.com/doi/10.1002/cam4.872/abstract

Language

en

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