Seventeen case series were included in the review (n=1,049). All studies had clearly described objectives, with inclusion criteria explicit in twelve. Fourteen studies reported length of follow-up. Patients were representative of the target population in all but one of the studies.
The overall rate of peri-operative morbidity ranged from 7% to 30% (median 22%) and the mortality rate ranged from 0% to 5% (median 0%). Duration of hospital stay ranged from eight to 22 days (median 12 days).
The median survival after initial hepatectomy was 26 to 73 months (seven studies), and the median survival since repeat hepatectomy ranged from 23 to 56 months. The following factors were found to be associated with improved survival after repeat hepatectomy: absence of extrahepatic disease at time of repeat hepatectomy; complete repeat hepatectomy; low serum carcinoembryonic antigen levels; solitary lesion; and small recurrence lesions.
The median disease-free survival ranged from nine to 52 months.
Further results were reported.