Background. Hepatic recurrence is seen in approximately 40% of patients und
ergoing hepatectomy for colorectal metastases. This study was designed to a
ssess the risks and clinical benefits of repeat hepatectomy for those patie
nts.
Methods. Twenty-six patients underwent repeat hepatectomy for hepatic recur
rence, and their clinical data were retrospectively reviewed for operative
morbidity and mortality performance level, and survival.
Results. There was no operative mortality after repeat hepatectomy. Operati
ve bleeding was significantly Increased in the second hepatectomy; but oper
ating time, duration of hospital stay, and performance status after the sec
ond hepatectomy were comparable with those of the initial hepatectomy. The
median survival time from the second hepatectomy was 31 months, and the 3-
and 5-year survival rates were 62 % and 32 %, respectively. A short disease
-free interval (6 months or less) between the initial hepatectomy and diagn
osis of hepatic recurrence in the remnant liver was significantly associate
d with poor survival after the second hepatectomy.
Conclusions. Repeat resection contributed to clinical benefits for selected
patients with hepatic recurrence after the initial hepatectomy for colorec
tal liver metastases. However appearance of hepatic recurrence within 6 mon
ths or less after the initial hepatectomy is a poor prognostic factor for r
epeat hepatectomy.