According to results recently published in the Archives of Surgery, repeat surgery to remove cancer that has spread to the liver provides significantly improved survival among patients with colorectal cancer.

Colorectal cancer is a commonly diagnosed cancer in the United States. Once advanced, the liver is a common place for colorectal cancer to spread. This is referred to as liver metastasis. There are several treatment options for liver metastasis, often depending upon the size, number, and location of the liver metastases, as well as the patient’s overall health and sites of cancer spread in the patient’s body.

The surgical removal of cancer, as well as surrounding tissue, in the liver is referred to as a hepatectomy. Surgery provides the best outcomes among patients with liver metastasis if the cancer has not spread to other sites in the body or has not spread throughout the liver. However, it is not common for patients with liver metastases to undergo a repeated hepatectomy.

Researchers from the John Wayne Cancer Institute recently evaluated data including treatment with repeat hepatectomies among patients with colorectal cancer and liver metastases. This study included 64 patients who underwent one or subsequent hepatectomies followed by chemotherapy.

• At five years median overall survival was 53%.

• At five years median disease-free survival was 25%.

• Among patients who experienced a cancer recurrence, five-year overall survival measured from the first hepatectomy was 73% among patients who underwent repeated hepatectomy, compared with 43% among patients without repeated hepatectomy.

The researchers concluded that “treatment of recurrent colorectal cancer confined to the liver should begin with consideration of repeated hepatectomy.”

Reference: Ahmad A, Chen S, Bilchik A, et al. Role of repeated hepatectomy in the multimodal treatment of hepatic colorectal metastases. Archives of Surgery. 2007;142:526-532.

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