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Repeat procedures for recurrent colorectal liver metastases: analysis of long-term liver regeneration and outcome

Authors Valdimarsson VT, Hellberg K, Brismar TB, Sparrelid E, Sturesson C

Received 21 October 2018

Accepted for publication 21 January 2019

Published 5 April 2019 Volume 2019:11 Pages 2617—2622

DOI https://doi.org/10.2147/CMAR.S191653

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Ms Justinn Cochran

Peer reviewer comments 3

Editor who approved publication: Dr Antonella D'Anneo


Valentinus T Valdimarsson,1 Katarina Hellberg,2 Torkel B Brismar,3 Ernesto Sparrelid,2 Christian Sturesson1,2

1Department of Clinical Sciences Lund, Surgery, Lund University, Skane University Hospital, Lund, Sweden; 2Division of Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden; 3Division of Radiology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

Background and aim: Repeat hepatectomy is increasingly performed for the management of recurrent colorectal liver metastases (CRLM). The aim of this study was to evaluate long-term functional liver volume (FLV) after a second hepatic procedure and to measure survival outcome.
Methods: In this retrospective cohort study, patients treated for recurrent CRLM in the years 2005–2015 at two liver centers were included. Total FLV was calculated before the first procedure and before and after the second procedure. Overall survival was calculated.
Results: Eighty-two patients were identified. The median follow-up was 53 (40–71) months from the first procedure. The median interval between first and second procedure was 13 (8–22) months. The initial FLV was 1584 (1313–1927) mL. The FLV was 1438 (1204–1896) mL after the first procedure and 1470 (1172–1699) mL after the second procedure (P<0.001). After the second procedure, a total of ten patients (12%) had a residual liver volume of less than 75% of the initial liver volume. The 5-year overall survival was 37 (26–54)% after the second procedure.
Conclusion: Small changes in FLV were found after two hepatic procedures but with considerable inter-individual variation. Patients selected for a repeated hepatic procedure for recurrent CRLM had an acceptable survival.

Keywords: liver metastases, colorectal cancer, repeat hepatectomy, liver regeneration, postoperative outcomes


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