The Significance of Second Hepatectomy for Reeurrent Metastases from Colorectal Primaries

Takeshi Tono, Nobuteru Kikkawa, Toshio Yagyu, Hideyuki Mishima, Yasuhiro Tamaki, Eisei Shin, Kenji Kobayashi, Yuichi Takatsuka

Department of Surgery, Osaka Naional Hospital

The significance of second hepatectomy for recurrent liver metastases from colorectal carcinoma was analyzed in this study. One hundred and seven patients underwent resection of the liver for colorectal carcinoma metastases between May 1979 and July 1994, ten of whom received a second hepatectomy for recurrent disease in the residual liver. Although the disease-free interval, size of the tumor, and number of metastases did not correlate with the prognosis after second hepatectomy, patients with multiple lesions in the bilateral hepatic lobe showed relapse to the remaining liver and died within several months of surgery. On the other hand, patients with recurrent lesions in the same hepatic lobe as the metastases at the first resection survived longer than 4 years without disease. The overall survival rates after second hepatectomy at 1, 3 and 5 years were 75.0%, 42.8% and 42.8%, and the disease-free survival rates were 66.7%, 33.3% and 33.3%, respectively, which were comparable to the result of the first hepatectomy. Therefore, second hepatic resection for liver metastases from colorectal cancer is very beneficial and should be aggressively performed in selected patients under careful diagnosis.

Key words
liver metastasis from colorectal carcinoma, second hepatectomy, recurrence after hepatic resection, hepatectomy for liver metastasis

Reprint requests
Takeshi Tono Department of Surgery, Osaka National Hospital
2-1-14 Hoenzaka, Cyuou-ku, Osaka 554 JAPAN

Accepted
November 9, 1994

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