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01-07-2013 | Review Article

A Systematic Review of Repeat Hepatectomy for Recurrent Colorectal Liver Metastases

Authors: Vincent W. T. Lam, Tony Pang, Jerome M. Laurence, Emma Johnston, Michael J. Hollands, Henry C. C. Pleass, Arthur J. Richardson

Published in: Journal of Gastrointestinal Surgery | Issue 7/2013

Abstract

Background

Selected patients with recurrent colorectal liver metastases (CLM) may be resectable by repeat hepatectomy approach. In this review, we aim to collate and evaluate the published evidence for repeat hepatectomy in patients with recurrent CLM.

Methods

Searches of the Medline and Embase databases were undertaken to identify studies of repeat hepatectomy in patients with recurrent CLM focusing on the perioperative treatment regimen, operative strategy, morbidity, technical success and survival outcomes.

Results

Twenty-two observational studies were reviewed. A total of 1,610 patients underwent second hepatectomy for recurrent CLM. The median percentage of extra-hepatic disease was 15 % (range, 0–39 %). Preoperative chemotherapy was reported in 5/22 studies. Major liver resection was undertaken in 25 % (range, 9–59 %) of patients and the R0 resection rate was 90 % (range, 77–96 %). Postoperative morbidity and mortality after the second hepatectomy were 23 % and 1.2 %, respectively. Recurrence rate after second hepatectomy was 63.9 % (range, 42–91 %) with a median follow-up period of 32 months (range, 19–59 months). Median overall survival was 35 months (range, 19–56 months). The 3-year and 5-year overall survival rates were 55 % (range, 11–82 %) and 42 % (range, 31–73 %), respectively.

Conclusion

Second hepatectomy is safe and feasible in selected patients with recurrent CLM and is associated with acceptable perioperative and survival outcomes. Future prospective studies are required to further define the patient selection criteria for repeat hepatectomy and the exact role of perioperative chemotherapy.

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Title: A Systematic Review of Repeat Hepatectomy for Recurrent Colorectal Liver Metastases
Authors: Vincent W. T. Lam
Tony Pang
Jerome M. Laurence
Emma Johnston
Michael J. Hollands
Henry C. C. Pleass
Arthur J. Richardson
Publication date: 01-07-2013
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 7/2013
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-013-2186-5

2024 ASCO Annual Meeting

Springer Medicine

A Systematic Review of Repeat Hepatectomy for Recurrent Colorectal Liver Metastases

Abstract

Background

Methods

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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