Elsevier

International Journal of Surgery

Volume 48, December 2017, Pages 281-285
International Journal of Surgery

Original Research
Long-term outcome and quality of life after initial and repeat resection of colorectal liver metastasis: A retrospective analysis

https://doi.org/10.1016/j.ijsu.2017.11.032Get rights and content
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Highlights

  • Repeat hepatic resection for colorectal liver metastasis is as effective as primary surgical treatment.

  • Patients should be selected carefully concerning prognostic factors.

  • Quality of life is not affected after a repeat resection.

Abstract

Background

Repeat hepatectomy is a widely accepted treatment for patients with recurrent colorectal liver metastasis (CRLM). The aim of this study was to compare initial and repeat hepatic resection concerning overall survival, prognostic factors and postoperative quality of life.

Methods

Data on patients who underwent initial or repeat hepatic resection for CRLM between 2010 and 2016 were prospectively collected and retrospectively evaluated. Follow-up data, EORTC QLQ-C30 and QLQ-LMC21 questionnaire results for quality of life (QoL) evaluation were analyzed.

Results

160 patients at a median age of 62.8 ± 11.8 years were analyzed. 122 were initially resected and 38 underwent a repeat hepatic resection. Disease-free survival (DSF) was superior in the initial resection group (p < 0.001), while there was no difference in overall survival (OS) (p = 0.288). BMI >30 (p = 0.012), extrahepatic tumor manifestation (p = 0.037), >1 CRLM manifestation (p = 0.009), and perioperative chemotherapy (p = 0.006) in the initial resection group and primary left colon tumor (p = 0.001) in the repeat resection group were identified as prognostic factors in multivariate Cox regression analysis. EORTC QLQ-LMC-21 module symptom score displayed an increased occurrence of a dry mouth in the initial hepatectomy group (p = 0.003). EORTC QLQ-C30 general functioning and symptom scores showed no difference.

Conclusion

Repeat hepatic resection for CRLM is as effective as primary surgical treatment in terms of OS and QoL. Patients should be selected carefully concerning prognostic factors as DFS is decreased after repeat hepatic resection.

Keywords

Colorectal liver metastasis
Hepatectomy
Quality of life

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