Repeated resection of colorectal liver metastases

The expansion of resection of colorectal hepatic metastases over the past two decades has been accompanied by a concomitant expansion of nonresectional options to treat patients with liver-only colorectal metastases. Comparative outcomes for different therapeutic strategies are largely unavailable or incomplete. Without sufficient equipoise to randomize the disparate population of patients with hepatic recurrence to all available therapeutic options, we will likely need to individualize our treatment strategies without the use of randomized trials. Clarifying the role of repeated hepatectomy for patients with recurrent disease requires knowledge of the outcomes, limitations, and alternatives for repeated resection of colorectal metastases. In this review, consideration of the published experience with hepatic re-resection can help define the boundaries and expectations for patient selection and outcomes.