Surgical and oncologic outcomes following repeat hepatic resection of colorectal liver metastasis: Who benefits?

Liam H. Wong, Thomas L. Sutton, Brett S. Walker, Charles D. Lopez, Adel Kardosh, Robert L. Eil, Emerson Y. Chen, Kevin G. Billingsley, Skye C. Mayo

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Resected colorectal liver metastases (CRLM) frequently recur intrahepatically. Selection criteria for repeat hepatectomy of recurrent CRLM are ill-defined. Methods: We performed an institutional review of patients with recurrent CRLM undergoing repeat hepatectomy from 2003 to 19. Post-recurrence overall (rOS) and recurrence-free survival (RFS) were analyzed with Cox proportional hazards modeling. Results: n = 147 experienced recurrent CRLM; 11% (n = 38) received repeat hepatectomy of which there was one Clavien-Dindo IIIa complication. Median rOS was 41 months; median RFS was 9 months. Improved rOS and RFS were independently associated with additional post-operative chemotherapy after repeat hepatectomy (HR 0.35 and 0.34, respectively); poor rOS with recurrent CRLM >3 cm (HR 4.4) and <12 months from first hepatectomy to recurrence (HR 4.8); poor RFS with ≥3 recurrence liver metastases (HR 2.8) (All P < 0.05). Discussion: Repeat hepatectomy for recurrent CRLM can be performed safely. Worse survival following repeat hepatectomy is independently associated with >3 cm and ≥3 liver lesions at recurrence, and <12 months to recurrence. Additional post-operative chemotherapy after repeat hepatectomy is associated with improved outcomes.

Original languageEnglish (US)
Pages (from-to)1114-1118
Number of pages5
JournalAmerican journal of surgery
Volume221
Issue number6
DOIs
StatePublished - Jun 2021

Keywords

  • Post-operative chemotherapy
  • Recurrent colorectal liver metastasis
  • Repeat hepatectomy

ASJC Scopus subject areas

  • Surgery

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