Journal of Clinical Oncology, Vol 12, 1491-1496, Copyright © 1994 by American Society of Clinical Oncology
Survival benefit of repeat liver resections for recurrent colorectal metastases: 143 cases. Association Francaise de Chirurgie
B Nordlinger, JC Vaillant, M Guiguet, P Balladur, F Paris, P Bachellier and D Jaeck
Centre de Chirurgie Digestive, Hopital Saint Antoine, Paris, France.
PURPOSE: Resection is the only chance for cure in patients with colorectal
liver metastases (LM). Five-year survival rates are close to 25%.
Unfortunately, recurrences occur in most patients. Some recurrent LM are
technically resectable. The aim of this study was to determine the risks
and benefits of repeat resections for recurrent LM. PATIENTS AND METHODS:
Data from 130 patients who received 143 repeat liver resections for
recurrent LM were collected. In 116 patients, only the liver was involved,
while 14 had both liver and extrahepatic recurrences. RESULTS: In the first
group, the operative mortality and morbidity rates were 0.9% and 24.7%,
respectively. Two- and 3-year survival rates were 57% and 33%,
respectively. Recurrences were observed in 66% of patients. Twelve patients
underwent a third hepatectomy for recurrence. The mortality rate was nil,
and the mean survival time was 12.5 months. In the group with liver and
extrahepatic metastases, the operative mortality and morbidity rates were
0% and 25%. The mean survival time was 16 months. Eleven patients died and
13 had recurrences during the follow-up period. CONCLUSION: Some hepatic
recurrences after surgical excision of colorectal metastases can be
resected with a low operative risk and with a long-term survival rate
similar to that obtained after first resections. This emphasizes the need
for a careful follow-up after hepatectomy for colorectal metastases to
detect resectable recurrences.
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