ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2019
Surgical Resection for Recurrence After Two-Stage Hepatectomy for Colorectal Liver Metastases Is Feasible, Is Safe, and Improves Survival.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Iterative Hepatic and Pulmonary Metastasectomy in Stage IV Colorectal Cancer: Impact on Survival and Surgical Outcomes.Annals of surgical oncology · 2026Article
- Recurrent Colorectal Liver Metastases: Opportunities for Biology-Informed Surgery Beyond Initial Hepatectomy.Annals of surgical oncology · 2025Article
- Strategies for Recurrent Colorectal Liver Metastases Based on Prognostic Factors and Resectability: Potential Benefit of Multidisciplinary Treatment.Annals of surgical oncology · 2025Article
- Adjuvant chemotherapy is associated with better oncological outcomes after ALPPS for colorectal liver metastases.Updates in surgery · 2024Observational
- Temporal evolution of metastatic disease: part II-a novel proposal for subcategorization of metastatic disease from non-neural solid tumors with diverse histologies and locations.Japanese journal of radiology · 2021Article
- Optimal patient selection for successful two-stage hepatectomy of bilateral colorectal liver metastases.Annals of gastroenterological surgery · 2021Review
- Prognostic and Therapeutic Implications of Tumor Biology, Including Gene Alterations, in Colorectal Liver Metastases.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Review
- Article
- Debate: Improvements in Systemic Therapies for Liver Metastases Will Increase the Role of Locoregional Treatments.Surgical oncology clinics of North America · 2021Review
- Gene mutation and surgical technique: Suggestion or more?Surgical oncology · 2020Review
- Innovation and Future Perspectives in the Treatment of Colorectal Liver Metastases.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2020Article
- Surgical approach to synchronous colorectal liver metastases: staged, combined, or reverse strategy.Hepatobiliary surgery and nutrition · 2020Review
- Possibility of repeat surgery for recurrence following two-stage hepatectomy for colorectal liver metastases: impact on patient outcome.Hepatobiliary surgery and nutrition · 2020Article
- Repeat hepatectomy for recurrent colorectal cancer liver metastases after two-stage hepatectomy-limitations and opportunities.Hepatobiliary surgery and nutrition · 2020Article
- Dealing with an insufficient future liver remnant: Portal vein embolization and two-stage hepatectomy.Journal of surgical oncology · 2019Review
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Authors and funding
11 authors.
Funding
Abstract
backgroundRecurrence rates are high for patients who have undergone two-stage hepatectomy (TSH) for bilateral colorectal liver metastases, and there is no established treatment approach for recurrent disease. This study aimed to determine the feasibility, safety, and prognostic impact of surgical resection for recurrence after TSH and the prognostic role of RAS mutation in this cohort.
methodsThe study included 137 patients intended to undergo TSH for bilateral colorectal metastases during 2003-2016. Clinicopathologic factors were compared using univariate and multivariate analyses.
resultsOne hundred eleven patients (81%) completed TSH. The median recurrence-free survival in these patients was 12 months. Of the 83 patients with subsequent recurrence, 31 (37%) underwent resection for recurrence, and 11 underwent multiple resections for recurrence. Forty-eight operations were performed for recurrence: 23 repeat hepatectomies, 14 pulmonary resections, 5 locoregional resections, and 6 concurrent resections in multiple organ sites. The median overall survival (OS) among patients with recurrence was 143 months for patients who underwent resection and 49 months for those who did not (P < 0.001). On multivariate analysis, resection for recurrence (hazard ratio [HR] 0.25; 95% CI 0.10-0.54, P < 0.001) was associated with better OS, whereas RAS mutation (HR 2.25; 95% CI 1.16-4.50, P = 0.016) and first recurrence in multiple sites (HR 2.28; 95% CI 1.17-4.37, P = 0.016) were independent predictors of worse overall survival.
conclusionsIn patients who have undergone TSH for bilateral colorectal liver metastases, recurrence is frequent and should be treated with resection whenever possible. Patients with wild-type RAS fare particularly well with resection for recurrence.
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