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- W2978847089 abstract "Purpose: The aim of this study was to evaluate the value of repeat hepatic resection for recurrent hepatic metastases from colorectal cancer and the clinicopathological factors influencing overall survival after repeat resection. Methods: Between 1992 and 2006, 271 consecutive patients underwent initial hepatic resection for metastases from colorectal cancer. Of these, 114 (42.1%) developed recurrences of remnant liver, and repeat hepatic resection was performed in the 38 patients. Clinicopathological features and long-term outcomes were compared between the initial hepatic resection and the repeat hepatic resection, and prognostic factors for repeat hepatic resections were analyzed. Hepatectomy was attempted if all tumors could be resected and residual liver function was adequate. Patients with resectable distant metastases were also seletcted. Results: Operative data: Operation time was not significantly different between the two groups (repeat resection: 457.4±153.9 minutes vs. initial resection: 430.5 ±150.0 minutes p=0.335). Operative bleeding was significantly increased in repeat hepatic resection as compared to initial resection (repeat: 1692.9±1511.5g vs. initial: 1266.6±1041.3g p=0.036). Postoperative hospital stay was similar (repeat: 17.9 ±9.5 days vs. initial: 20.2±11.2 days p=0.249). Morbidity and mortality: The morbidity after repeat hepatic resection was similar to that after initial resection (repeat: 15.8% vs. initial: 27.3% p=0.129). One patient died within 30 days after initial hepatic resection (0.37%, 1/271). However there was no postoperative mortality in the 38 patients who underwent repeat hepatic resection. Long-term outcome: The overall cumulative 1-, 3- and 5-year survival rates, and median survival time, for the 38 repeat hepatic resection (100%, 79.9% and 53.8%, and 60 months,respectively) did not differ from those for the initial hepatic resection (89.0%, 60.4% and 48.8%, and 50 months, respectively, p=0.275) There was no significant difference in remnant liver 5-year hepatic recurrence-free survival rate between the repeat resection (49.2%) and the initial resection (50.8%) (p=0.934). Prognostic factor after repeat hepatic resection: In the univariate analysis, surgical margin less than 5mm was identified as poor prognostic factor for repeat hepatic resection (p=0.047). Conclusion: Repeat hepatic resection can provide long-term survival rates similar to those of initial hepatic resection, with no mortality and comparable morbidity. Achieving a safety surgical margin is the relevant prognostic factor for a favourable prognosis after repeat hepatic resection." @default.
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- W2978847089 date "2009-10-01" @default.
- W2978847089 modified "2023-09-25" @default.
- W2978847089 title "Repeat Hepatic Resection for Recurrent Liver Metastases from Colorectal Cancer" @default.
- W2978847089 doi "https://doi.org/10.14309/00000434-200910003-00437" @default.
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