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

D. Heise*, W. Bayings, A. Tuinhof, R. Eickhoff, A. Kroh, F. Ulmer, C. H. C. Dejong, U. Neumann, M. Binneboesel

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

10 Citations (Web of Science)

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-LMC21 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.

Original languageEnglish
Pages (from-to)281-285
Number of pages5
JournalInternational Journal of Surgery
Volume48
DOIs
Publication statusPublished - Dec 2017

Keywords

  • Colorectal liver metastasis
  • Hepatectomy
  • Quality of life
  • HEPATIC RESECTION
  • CANCER
  • SURVIVAL
  • SURGERY
  • CHEMOTHERAPY
  • HEPATECTOMY
  • RECURRENCE
  • TRIALS
  • CARCINOMA
  • IMPACT

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