Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 21, 2015; 21(7): 2124-2130
Published online Feb 21, 2015. doi: 10.3748/wjg.v21.i7.2124
Repeat hepatic resection in patients with colorectal liver metastases
Huisong Lee, Seong Ho Choi, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee, Jin Seok Heo, Dong Wook Choi, Kyung Uk Jung, Ho-Kyung Chun
Huisong Lee, Seong Ho Choi, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee, Jin Seok Heo, Dong Wook Choi, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea
Kyung Uk Jung, Ho-Kyung Chun, Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea
Author contributions: Choi SH is the guarantor of this entire study; all authors participated in the study design and data analysis; all authors participated in drafting the article and gave final approval; Literature research was done by Lee H, Kim HC, Choi DW; clinical studies were performed by Choi SH, Lee WY, Heo JS, and Choi DW; statistical analyses were conducted by Lee H, Heo JS, Yun SH and Jung KU; manuscript editing was carried out by all authors.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Seong Ho Choi, MD, PhD, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, South Korea. sh3468.choi@samsung.com
Telephone: +82-10-9933-3468 Fax: +82-2-3410-6980
Received: July 13, 2014
Peer-review started: July 14, 2014
First decision: August 15, 2014
Revised: September 1, 2014
Accepted: September 29, 2014
Article in press: September 30, 2014
Published online: February 21, 2015
Processing time: 212 Days and 17.1 Hours
Abstract

AIM: To investigate the survival outcomes of secondary hepatectomy for recurrent colorectal liver metastases (CRLM).

METHODS: From October 1994 to December 2009, patients with CRLM who underwent surgical treatment with curative intent were investigated. Patients were divided into two groups: patients who underwent primary hepatectomy (Group 1) and those who underwent secondary hepatectomy for recurrent CRLM (Group 2).

RESULTS: Survival and prognostic factors were analyzed. A total of 461 patients were included: 406 patients in Group 1 and 55 patients in Group 2. After a median 39-mo (range, 3-195 mo) follow-up, there was a significant difference between Groups 1 and 2 in terms of disease-free survival (P = 0.029) although there was no significant difference in overall survival (P = 0.206). Secondary hepatectomy was less effective in patients with multiple recurrent CRLM than primary hepatectomy for initial CRLM (P = 0.008). Multiple CRLM and radiofrequency ablation therapy were poor prognostic factors of secondary hepatectomy in multivariate Cox regression analysis (P = 0.006, P = 0.004, respectively).

CONCLUSION: Secondary hepatectomy for single recurrent CRLM is as effective as primary surgical treatment for single recurrent CRLM. However, secondary hepatectomy for multiple recurrent CRLM is less effective than that for single recurrent CRLM.

Keywords: Colorectal neoplasm; Metastasis; Recurrence; Hepatectomy

Core tip: Secondary hepatectomy for single recurrent colorectal liver metastases (CRLM) is as effective as primary surgical treatment for single recurrent CRLM. However, secondary hepatectomy for multiple recurrent CRLM is less effective than that for single recurrent CRLM.