Meta-analysis of clinical outcome and safety of repeat hepatectomy versus first hepatectomy for patient with live metastases from colorectal cancer

Objective To compare clinical outcomes and safety of repeat hepatectomy for patients with liver metastases from colorectal cancer with those of a first liver resection. Methods The literature was searched for all studies reported on repeat hepatectomy versus a first liver resection patients with liver metastases from colorectal cancer between January 1992 to June 2010. According to inclusion and exclusion criteria, the clinical data were extracted. Trials were assessed using the modified Newcastle-Ottawa Score. Analysis were performed by RevMan 4.2. Results Twenty-two clinical studies were included in our systematic reviews. Compared with the first liver resection group, operation time of the repeat hepatectomy group was longer by 39 minutes[95% CI(-65.21, -23.13), P<0.00001], intraoperatie blood transfusions was longer by 1.1 U [95% CI(-1.75, -0.79), P<0.00001]. There were no significant differences in the number of patient of length of intensive care unit stay, blood loss, length of hospitalization. There were no significant differences in the morbidity rate of post-operation complications, 1,3,5-year overall survival, disease-free surial, the incidence of recurrence between the two groups. Conclusions Repeat hepatectomy for patients with colorectal cancer metastases is safe and provides survival benefit equal to that of a first liver resection. Repeat hepatectomy is first selection scheme, but in order to get a more effective long-term outcome, further consider comprehensive treatment should be considered. Key words: Colorectal neoplasms; Liver metastases; First hepatectomy; Repeat hepatectomy