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A systematic review and meta-analysis of the utility of repeated versus single hepatic resection for colorectal cancer liver metastases

Background Recurrence of colorectal liver metastases after a first hepatectomy is common (4-48% of patients). This review investigates the utility of repeated hepatic resection of colorectal liver metastases. MethodsA systematic search of the literature was performed in the Cochrane Library, MEDLINE...

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Main Authors: Wurster, Elena Felicia (Author) , Tenckhoff, Solveig (Author) , Probst, Pascal (Author) , Jensen, Katrin (Author) , Dölger, Eva (Author) , Knebel, Phillip (Author) , Diener, Markus K. (Author) , Büchler, Markus W. (Author) , Ulrich, Alexis (Author)
Format: Article (Journal)
Language:English
Published: June 2017
In: HPB
Year: 2017, Volume: 19, Issue: 6, Pages: 491-497
ISSN:1477-2574
DOI:10.1016/j.hpb.2017.02.440
Online Access:Verlag, Volltext: http://dx.doi.org/10.1016/j.hpb.2017.02.440
Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S1365182X17305154
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Author Notes:Elena F. Wurster, Solveig Tenckhoff, Pascal Probst, Katrin Jensen, Eva Dölger, Phillip Knebel, Markus K. Diener, Markus W. Büchler & Alexis Ulrich
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Summary:Background Recurrence of colorectal liver metastases after a first hepatectomy is common (4-48% of patients). This review investigates the utility of repeated hepatic resection of colorectal liver metastases. MethodsA systematic search of the literature was performed in the Cochrane Library, MEDLINE, EMBASE, and trial registers. All studies comparing repeated hepatic resection for colorectal liver metastases with patients who underwent only one hepatectomy were eligible. Outcome criteria were safety parameters and survival rates. Data were analyzed using the random-effects model.Results In eight observational clinical studies, 450 patients with repeated hepatic resection were compared with 2669 single hepatic resections. Morbidity such as hepatic insufficiency (OR [95% CI] 1.46 [0.69; 3.08], p = 0.32) and biliary leakage and fistula (OR [95% CI] 1.22 [0.80; 1.85], p = 0.35) was comparable between the two groups. Mortality (OR [95% CI] 1.13 [0.46; 2.74], p = 0.79) and overall survival (HR [95% CI] 1.00 [0.63; 1.60], p = 0.99) were not significantly different between the two groups. Discussion Repeated hepatic resection for colorectal liver metastases is safe in selected patients. A prospective, multicenter high-quality trial or register study of repeated hepatic resection will be required to clarify patient-oriented outcomes such as overall survival and quality of life.
Item Description:Available online 25 March 2017
Gesehen am 23.10.2018
Physical Description:Online Resource
ISSN:1477-2574
DOI:10.1016/j.hpb.2017.02.440

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