Resection for Recurrent Colorectal Liver Metastases

  • Konstantine Avradopolous
  • Harold J. Wanebo
  • Sam G. Pappas
Part of the Cancer Treatment and Research book series (CTAR, volume 109)


Colorectal cancer is one of the most common gastrointestinal cancers worldwide. It is estimated that in the year 2001, 130,200 colorectal cases will be diagnosed in the United States. Also over the next year, 56,300 Americans will die of this disease. Colorectal cancer ranks third in estimated cancer deaths, behind lung and prostate cancer in men, and lung and breast cancer in women (1). The vast majority of these patients die of metastases (2,3). Among patients diagnosed with colorectal cancer, during the course of their illness, the liver will become involved in 40-70% of cases. It has been well documented that the treatment of choice, on first presentation of hepatic metastases, is surgical resection (4–7). Numerous series report 5-year survival rates of 22%–39%, with an average around 30% (4–7). Unfortunately, this means that 70% of patients will recur after hepatic resection for colorectal metastases. Among these patients, about 30% will present with liver only recurrences, and about one third to one half of these will be candidates for a second hepatic resection (2,3).


Liver Resection Hepatic Resection Hepatic Metastasis Extrahepatic Disease Colorectal Metastasis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    CA Journal 15(1):12–16 January/February 2000.Google Scholar
  2. 2.
    Nicolson GL. Generation of phenotypic diversity and progression in metastatic tumor cells. Cancer Metastases Rev 3:25–42, 1984.CrossRefGoogle Scholar
  3. 3.
    Vezeridis MP. Biology of metastases, In: Wanebo HJ, editor. Colorectal Cancer. St Louis: Mosby-Year Book Inc. 26–105, 1993.Google Scholar
  4. 4.
    Foster JH, Lund J. Liver metastasis. Cur Prob Surg 18:158, 1981.Google Scholar
  5. 5.
    Welch JP, Donaldson GA. Clinical correlation of an autopsy study of recurrent colorectal cancer. Ann Surg 189:496–502, 1979.PubMedCrossRefGoogle Scholar
  6. 6.
    Rosen CD, Gordy DM, Tasso HS, et al. Perioperative blood transfusion and determinants of survival after liver resection for metastatic colorectal carcinoma. Ann Surg 216:493–505, 1992.PubMedCrossRefGoogle Scholar
  7. 7.
    Scheele J, Stengle R, Altendoor-Hoffman A, et al. Indicators of prognosis after hepatic resection for colorectal secondary. Surgery 110:15–29 1991.Google Scholar
  8. 8.
    Kemeny NM, Sugarbaker PH, Smith TJ, et al. A prospective analysis of laboratory tests and endocrine studies can detect hepatic lesions. Ann Surg 195:163–167, 1982.PubMedCrossRefGoogle Scholar
  9. 9.
    Fong Y, Kemeny NM, Paty P, Blumgart LH, Cohen A. Treatment of colorectal cancer: hepatic metastasis. Sem Surg Onc 12:219–252, 1996.CrossRefGoogle Scholar
  10. 10.
    Jaffe BN, Donnigen WL, Watson F. Factors influencing survival in patients with untreated hepatic metastasis. Surg Gyn Obstet 172:1–11, 1968.Google Scholar
  11. 11.
    Bengmark S, Hafstrom L. The natural history of primary and secondary malignant tumors of the liver: The Prognosis for cases of hepatic metastasis from colonic and rectal carcinoma at laparotomy. Cancer 23:198–202, 1969.PubMedCrossRefGoogle Scholar
  12. 12.
    Goslin R, Steele D, Zantic ET, et al. Factors influencing survival in patients with hepatic metastasis from adenocarcinoma of the colon and rectum. Dis Colon Rectum 25:749–754, 1982.PubMedCrossRefGoogle Scholar
  13. 13.
    Bengtssongon G, Carlsson G, Hasstrom L. Natural history of patients with untreated liver metastasis from colorectal cancer. Am J Surg 141:586–589, 1981.CrossRefGoogle Scholar
  14. 14.
    Wood CB, Gillis CR, Blumgard LH. A retrospective study of the natural history of patients with global metastasis from colorectal cancer. Clin Onc 2:285–288, 1976.Google Scholar
  15. 15.
    Bismuth AH, Adam R, Nevarro S, Castaing D, et al. Re-resection for colorectal liver metastases. Surg Onc Clin North America 5(2):353–364, April 1996.Google Scholar
  16. 16.
    Cady B, McDermott WV. Major hepatic resection for metacrenous metastasis from colon cancer. Ann Surg 201:204–209, 1985.PubMedCrossRefGoogle Scholar
  17. 17.
    Ekberg GH, Tranberg KJ, Anderson R, et al. Patterns of recurrence in liver resection for colorectal secondaries. World J Surg 11:541–547, 1987.PubMedCrossRefGoogle Scholar
  18. 18.
    Fortner JG, Silva JS, Goby RB, et al. Multivariate analysis of a personal series of 247 consecutive cases of liver metastasis from colorectal cancer. Ann Surg 199:306–316, 1984.PubMedCrossRefGoogle Scholar
  19. 19.
    Hughes KS, Simon R, Song RO, Body S, et al. Resection of the liver for colorectal carcinoma metastasis: A multi-institutional study of patterns of recurrence. Surgery 100:278–284, 1986.PubMedGoogle Scholar
  20. 20.
    Fortner JG. Recurrence of colorectal cancer after hepatic resection. Am J Surg 155:378–382, 1988.PubMedCrossRefGoogle Scholar
  21. 21.
    Nagasue N, Yukaya H, Ogawa Y, et al. Human liver regeneration after major hepatic resection. Ann Surg 206:30–39, 1987.PubMedCrossRefGoogle Scholar
  22. 22.
    Elias D, Lasser PH, Huang JM, et al. Repeat hepatectomy for cancer. Br J Surg 80:1557–1562, 1993.PubMedCrossRefGoogle Scholar
  23. 23.
    Foster JH, Lundy J. Liver metastasis. Curr Probl Surg 18:(3) 157–202, 1981.PubMedCrossRefGoogle Scholar
  24. 24.
    August DA, Sugarbaker PH, Otto RT, et al. Hepatic resection for colorectal metastases: influence of clinical factors in adjuvant 5-FU administered through a catheter. Ann Surg 201:210–218, 1985.PubMedCrossRefGoogle Scholar
  25. 25.
    Adam R, Bismuth H, Castaing D, Wauchter F, et al. Repeat hepatectomy for colorectal liver metastases. Ann Surg 225:51–62, 1997.PubMedCrossRefGoogle Scholar
  26. 26.
    de la Vega T, Donahue E, Dulas A, et al. A ten-year experience with hepatic resection. Surg Gyn Obstet 159:223–228, 1985.Google Scholar
  27. 27.
    Trego VF, Shamsa F. Repeat resection for colorectal metastasis. In Hepatobility Cancer textbook. Kluwer Academic Publishers, Boston 1994.Google Scholar
  28. 28.
    Gazziniga GM, Ciferri E, Gazio S, Bagaloro C, Muni CO, et al. Repeated hepatic resections for repeat hepatic metastasis of colorectal cancer. Hepatic Gastroenterology 42: 383–386, 1995.Google Scholar
  29. 29.
    Bines SD, Doolas A, Jenkins L, Millikan K, Roseman D. Survival after repeat hepatic resection for recurrent colorectal hepatic metastases. Surgery 120:(4) 591–596, 1996.PubMedCrossRefGoogle Scholar
  30. 30.
    Pinson CW, Wright JK, Chapman WC, Girrard CL, et al. Repeat hepatic surgery to colorectal cancer metastasis to the liver. Ann Surg 223: (6) 765–776. 1996.PubMedCrossRefGoogle Scholar
  31. 31.
    Tuttle TM, Curley SA, Rao MS. Repeat hepatic resection as effective treatment of recurrent colorectal liver metastases. Ann Surg Onc 4:(2)125–130, 1997.CrossRefGoogle Scholar
  32. 32.
    Neidleman N, Anderson R. Repeated liver resections for recurrent liver cancer. Br J Surg 83:893–901, 1996.CrossRefGoogle Scholar
  33. 33.
    Adam R, Bismuth H, Castaing D, Waechter F, et al. Repeat hepatectomy for colorectal liver metastases. Ann Surg 225:(1) 51–62, 1997.PubMedCrossRefGoogle Scholar
  34. 34.
    Kin T, Nakajima Y, Kanehiro H, Hisanaga M, et al. Repeat hepatectomy for recurrent colorectal metastases. World J Surg 22:(10) 1087–1091, 1998.PubMedCrossRefGoogle Scholar
  35. 35.
    Chiappa A, Zbar AP, Biella FB, Staudacher C. Survival after repeat hepatic resection for recurrent colorectal metastases. Hepato-Gastroenterology 46:1065–1070. 1999.PubMedGoogle Scholar
  36. 36.
    Bradley A, Capman W, Wright JK, March JW, et al. Reporting a surgical experience with hepatic colorectal metastasis. The American Surgeon 65:560–567, 1999.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2001

Authors and Affiliations

  • Konstantine Avradopolous
    • 1
  • Harold J. Wanebo
    • 1
  • Sam G. Pappas
    • 2
  1. 1.Roger Williams Medical CenterProvidenceUSA
  2. 2.Northwestern University Medical SchoolChicagoUSA

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