OBJECTIVE: Hepatic resection for recurrent @entity43 is controversial because of the paucity of relevant published data. The principles of cytoreduction before chemotherapy suggest that resection of measurable liver lesions in properly selected @entity1 would be beneficial. To determine the effect of resection of metachronous liver metastases on morbidity and survival, we reviewed our experience with this treatment. METHODS: Medical records were reviewed retrospectively for all @entity1 who had anatomic hepatic resection for metachronous parenchymal liver metastases from @entity43 (epithelial or malignant mixed @entity5 ) at Mayo Clinic from 1976 to 1999. RESULTS: We identified 26 @entity1 (median age at hepatic resection, 62 years; range, 39-75 years) who had hepatic resection requiring complete segmentectomies or more extensive hepatic surgery for recurrent @entity43 . Cytoreduction was optimal (extrahepatic and @entity99 <or=1 cm) in 21 @entity1 and suboptimal in 5. No intraoperative or postoperative @entity204 occurred. Aside from @entity190 requiring transfusion of more than 4 units of erythrocytes in 4 @entity1 , only two complications were noted: one superficial wound infection and one small-bowel perforation that required reoperation. The overall median disease-related survival was 26.3 months after hepatic resection; 18 @entity1 (69%) died of disease at a median of 14.6 months (range, 5.0-41.3 months). However, 8 @entity1 (31%) were alive at median follow-up of 33.2 months (range, 3.6-49.6 months). Factors significantly associated with improved disease-related survival were consistent with known prognostic factors associated with cytoreductive surgery, including more than 12 months since original diagnosis (27.3 vs 5.7 months, P = 0.004) and less than or equal to 1 cm of @entity66 after hepatic resection (27.3 vs 8.6 months, P = 0.031). CONCLUSIONS: We present evidence that hepatic resection can be performed with minimal surgical morbidity and mortality by surgical teams trained in the procedures. Because of the disease-related survival advantage afforded @entity1 by optimal cytoreductive surgery, parenchymal liver metastases should not preclude secondary cytoreductive surgical efforts.

Hepatic resection for metachronous metastases from XXXX .

@entity43 :: ('MESH:D010051', 'Disease') :: ['ovarian carcinoma'] @entity1 :: ('9606', 'Species') :: ['women', 'patients'] @entity66 :: ('MESH:D004194', 'Disease') :: ['residual disease'] @entity5 :: ('MESH:D009369', 'Disease') :: ['M  llerian tumors'] @entity190 :: ('MESH:D006473', 'Disease') :: ['blood loss'] @entity99 :: ('MESH:D056486', 'Disease') :: ['hepatic residual disease'] @entity204 :: ('MESH:D003643', 'Disease') :: ['deaths']
@entity43 :: (MESH:D010051,Disease) :: ['ovarian carcinoma']
