REPEATED HEPATIC RESECTIONS FOR COLORECTA L LIVER METASTASES

For patients with recurrent operable liver metastases from colorectal cancer operative resection is the only chance of getting rid of their tumorous disease for a longer time. As there are not therapeutic alter natives more and more authors are reporting on repeated resections of liver metastases. From 1986 to 1994 we performed 12 recurrent liver re sections with curative intent in 8 patients suffering from liver metas tases of colorectal cancer: 4 synchronous and 4 metachronous metastase s were removed, the primary procedure being anatomic hemihepatectomy i n 5 cases and segmentectomy or bisegmentectomy in 3 cases. The mean ti me interval between the first and the second resections was 14 (4-23) months. Two patients underwent 4 consecutive liver resections because of recurrent metastases. In these cases the interval between the secon d, third and fourth procedures was 10 months. The postoperative compli cation rate was 16% and not a single patient died in hospital. Three p atients died an average of 28 (9-54) months after the last liver resec tion, and the other 5 patients are still alive after an average of 14 (4-28) months: 3 are free of tumor and 2 have recurrent metastases in the liver. Compared with untreated or only locally treated cases, pati ents in whom operative risk is low can achieve prolonged survival time s after resections of colorectal metastases to the liver.