A second liver resection due to recurrent colorectal liver metastases.

BACKGROUND Repeat liver resection because of recurrent colorectal liver metastases can provide survival benefit with a low rate of complications. DESIGN Retrospective study. PARTICIPANTS Forty patients who underwent a second hepatectomy because of liver metastases from colorectal cancer. MAIN OUTCOME MEASURES Short- and long-term results of a second hepatectomy and determination of prognostic factors. RESULTS The postoperative mortality rate was 2.5%. The postoperative morbidity rate was not significantly different after a second hepatectomy compared with single hepatectomy (42.5% and 27.5%, respectively; P = .10). Transfusion requirement and hospital stay were comparable for both a single and a second hepatectomy. Three- and 5-year overall survival rates were 55% and 31%, respectively. Disease-free survival rates at 3 and 5 years were, respectively, 49% and 27%. The interval between first and second hepatectomies and the presence of extrahepatic disease were independently related to survival (multivariate analysis). CONCLUSIONS A second liver resection because of recurrent liver metastases from colorectal cancer is safe and provides a survival benefit similar to that with single hepatectomy. Our analysis suggests that the benefit of treatment is limited in patients who undergo a second hepatectomy within 1 year of the first operation and in those with extrahepatic disease.