Surgical Strategy for Recurrence of Liver Metastases

Recurrence of liver metastases is usually observed within two years of liver surgery [62, 63]. The most frequent sites of recurrence after liver resection are reported in Table 8.

After accurate staging of liver recurrence in relation to tumour stage, patients may be submitted to liver re-resection, ablative technique or chemotherapy.

Re-resection is feasible in only 20% of patients.

Results of re-resection are comparable with those of the first hepatectomy in terms of mortality and morbidity. Long-term results are good, with 5-year survival ranging from 16 to 57%. Further recurrences may be submitted to repeated liver resection with good results when radical resection is feasible [22, 64].

Local ablative techniques, mainly radiofrequency ablation, have been applied in this particular setting. Local efficacy of these therapies are good for small lesions but efficacy in terms of survival is not clear, even though some authors reported results comparable with surgical resection [67].

Only surgery, nowadays, guarantees good long-term survival in the case of tumour recurrence.

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