Second liver resections are safe and effective treatment for recurrent hepatic metastases from colorectal cancer: A bi-institutional analysis Journal Article
| Authors: | Petrowsky, H.; Gonen, M.; Jarnagin, W.; Lorenz, M.; DeMatteo, R.; Heinrich, S.; Encke, A.; Blumgart, L.; Fong, Y. |
| Article Title: | Second liver resections are safe and effective treatment for recurrent hepatic metastases from colorectal cancer: A bi-institutional analysis |
| Abstract: | Objective: To determine the value of repeat liver resection for recurrent colorectal metastases to the liver. Summary Background Data: Liver resection represents the best and a potentially curative treatment for metastatic colorectal cancer to the liver. After resection, however, most patients develop recurrent disease, often isolated to the liver. Methods: This study reports the combined experience of repeat liver resection for recurrent liver metastases at an American and a European surgical oncology center. Patients were identified from prospective databases and records were retrospectively reviewed. A total of 126 patients (American n = 96, 1986-2001; European n = 30, 1985-1999) underwent repeat liver resection. Patient characteristics were similar in the two institutions. Median follow-up from first liver resection was 88 and 105 months, respectively. Results: Operations performed included 90 minor resections and 36 resections of a lobe or more. The 1-, 3-, and 5-year survival rates were 86%, 51%, and 34%. There were 19 actual 5-year survivors to date. By multivariate regression analysis (proportional hazard model), more than one lesion and tumor size larger than 5 cm were independent prognostic indicators of reduced survival. The interval between the first and second liver resection was not predictive of outcome. Conclusions: Repeat liver resection for colorectal liver metastases is safe. Patients with a low tumor load are the best candidates for a repeat resection. In well-selected patients, further resection of the liver can provide prolonged survival after recurrence of colorectal liver metastases. |
| Keywords: | adult; cancer survival; controlled study; human tissue; treatment outcome; aged; aged, 80 and over; middle aged; survival analysis; retrospective studies; major clinical study; clinical feature; liver neoplasms; conference paper; cancer adjuvant therapy; chemotherapy, adjuvant; recurrent cancer; antineoplastic agent; neoplasm staging; neoplasm recurrence, local; tumor volume; risk factors; surgical approach; retrospective study; colorectal carcinoma; colorectal neoplasms; liver metastasis; reoperation; liver resection; hepatectomy; multivariate analysis; safety; regression analysis; humans; prognosis; human; male; female; priority journal |
| Journal Title: | Annals of Surgery |
| Volume: | 235 |
| Issue: | 6 |
| ISSN: | 0003-4932 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2002-06-01 |
| Start Page: | 863 |
| End Page: | 871 |
| Language: | English |
| DOI: | 10.1097/00000658-200206000-00015 |
| PUBMED: | 12035044 |
| PROVIDER: | scopus |
| PMCID: | PMC1422517 |
| DOI/URL: | |
| Notes: | Presented at the 113th Annual Session of the Southern Surgical Association; 2001 Dec 3–5; Hot Springs, VA -- Export Date: 14 November 2014 -- Source: Scopus |
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