Repeat hepatectomy for recurrent colorectal liver metastases:A comparative analysis of short-and long-term results

• 作者: Paulo Figueiredo Costa Fabricio Ferreira Coelho Vagner Birk Jeismann Jaime Arthur Pirola Kruger Gilton Marques Fonseca Ivan Cecconello Paulo Herman
• 来源期刊: 国际肝胆胰疾病杂志（英文版）
• 年，卷（期）: 2022,（2）
• 所属期刊栏目: Liver
• 页码范围: 162-167
• 页数: 6页
• 语种: 英文

摘要

Background:Liver recurrence after resection of colorectal liver metastases(CRLM)is frequent.Repeat hepatectomy has been shown to have satisfactory perioperative results.However,the long-term outcomes and the benefits for patients with early recurrence have not been clarified.The aim of this study was to compare the short-and long-term outcomes of patients undergoing single hepatectomy and repeat hepatectomy for CRLM.Additionally,the oncological outcomes of patients with early(≤6 months)and late recurrence who underwent repeat hepatectomy were compared.Methods:Consecutive adult patients undergoing hepatectomy for CRLM between June 2000 and February 2020 were included and divided into two groups:single hepatectomy and repeat hepatectomy.Results:A total of 709 patients were included:649 in the single hepatectomy group and 60 in the repeat hepatectomy group.Patients in the repeat hepatectomy group underwent more cycles of preoperative chemotherapy[4(3-6)vs.3(2-4),P=0.003].Patients in the single hepatectomy group more frequently underwent major hepatectomies(34.5％vs.16.7％,P=0.004)and had a greater number of lesions re-sected(2.9±3.6 vs.1.9±1.8,P=0.011).There was no increase in operative time,estimated blood loss,length of hospital stay,complications,or mortality in the repeat hepatectomy group.There were no dif-ferences in overall survival(P=0.626)and disease-free survival(P=0.579)between the two groups.Similarly,for patients underwent repeat hepatectomy,no difference was observed between the early and late recurrence groups in terms of overall survival(P=0.771)or disease-free survival(P=0.350).Conclusions:Repeat hepatectomy is feasible and safe,with similar short-and long-term outcomes when compared to single hepatectomy.Surgical treatment of early liver recurrence offers similar oncological outcomes to those obtained for late recurrence.