SURVIVAL AFTER REPEAT HEPATIC RESECTION FOR RECURRENT COLORECTAL HEPATIC METASTASES

Background. This is a retrospective clinical study done to examine sur vival of patients undergoing repeat hepatic resection for recurrent co lorectal hepatic metastases. Methods. The records of 131 patients unde rgoing hepatic resection for metastatic colorectal cancer were reviewe d. Curative resection was performed in 107 of these patients. Thirty-o ne experienced recurrences confined to the liver. Thirteen (13 of 107, 12%) of them underwent resection and make up the study population. Re sults. The eight men (62%) and five women (38%) had a median age of 60 years (range, 32 to 75 years). In 30% of patients recurrence develope d near the original resection site. In 70% the recurrences were remote from the original site. The patients underwent a total of six wedge r esections, two left lateral segmentectomies, three right lobectomies, and two trisegmentectomies. Average blood loss was 2995 cc; average ho spital stay was 17.2 days. Morbidity was 23% (3 of 13); mortality was 8% (1 of 13). Four patients died of recurrent disease, with a mean dis ease-free survival of 9.7 months (median, 7.5 months; range, 3 to 21 m onths) and mean total survival of 39 months (median, 24 months; range, 8 to 99 months). One of these patients had a second recurrence resect ed at month 21 and lived an additional 78 months. Seven patients were alive with no evidence of disease, with a mean follow-up time of 34.9 months (median, 14 months; range, 1 to 186 months). Actual 5-year surv ival was 23% (3 of 13), Actual disease-free 5-year survival was 15% (2 of 13). Conclusions. In properly selected patients morbidity, mortali ty, and survival after repeat resection are similar to those after ini tial resection.