Second surgery or chemotherapy for relapse after radical resection of colorectal cancer metastases

Giovanni Brandi, Jody Corbelli, Francesco De Rosa, Stefania Di Girolamo, Ciro Longobardi, Valentina Agostini, Ingrid Garajová, Stefano La Rovere, Giorgio Ercolani, Gian Luca Grazi, Antonio Daniele Pinna, Guido Biasco

Research output: Contribution to journalArticlepeer-review


Purpose: Limited data suggest that second resections for colorectal cancer metastases may improve survival, but no study has compared surgery with chemotherapy in this setting. Therefore, we retrospectively compared the clinical outcome of potentially resectable patients who received a second metastasectomy with those who did not in our single-centre experience. Methods: We retrospectively reviewed the clinical records of all patients treated for metastatic colorectal cancer in our centre over a period of 12 years. We selected patients who relapsed after radical resection of metastases from colorectal cancer and were deemed resectable again by our multidisciplinary team. We then compared the clinical outcome of those who received a second operation with those who refused surgery and also evaluated the role of prognostic factors. Results: We identified 60 patients fulfilling the inclusion criteria. Twenty-nine underwent a second resection and 31 refused surgery. Median overall survival rates were 58.7 and 24.0 months, median times to progression were 14.4 and 6.6 months. Patients who received surgery plus perioperatory chemotherapy (18/29) had a significantly better outcome; 4/29 achieved long-term disease-free survival. Conclusions: Our study suggests that in highly selected metastatic colorectal cancer patients, a multimodal treatment plan, including a second resection, can achieve longer survival with respect to medical therapy.

Original languageEnglish
Pages (from-to)1069-1077
Number of pages9
JournalLangenbeck's Archives of Surgery
Issue number7
Publication statusPublished - Oct 2012


  • Adjuvant therapy
  • Colorectal cancer metastases
  • Integrated treatment
  • Metastasectomy
  • Neoadjuvant therapy

ASJC Scopus subject areas

  • Surgery


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