Introduction: Complete resection of recurrent hepatic colorectal metastases results in a median survival of 30-40 months. However, the impact of the extent of surgical resection on outcome has not been well defined. Methods: Patients with recurrent hepatic colorectal metastases undergoing surgical resection were identified from a prospective database. Patient outcome was analyzed according to the type of surgical treatment: anatomic resection (segmental or larger excision) vs. nonanatomic resection (wedge resection or tumor ablation). Demographic data, tumor characteristics, and survival were analyzed. Results: From 1993 to 2005, 48 procedures were performed in 40 patients with recurrent hepatic colorectal metastases, including 15 anatomic and 33 nonanatomic resections. There was no difference in clinicopathologic risk factors between the two groups, including size of largest tumor, number of tumors, preoperative CEA, disease-free interval, node positive primary tumor, or use of adjuvant therapy. Patients who underwent hepatic ablation did so because of tumor location, poor hepatic reserve, or medical comorbidities. In patients treated curatively, there was an improvement in overall and disease-free survival in patients undergoing anatomic resection (Table, median FU 16 months). No other clinicopathologic feature was predictive of overall or disease-free survival. Conclusions: In patients with recurrent hepatic colorectal metastases, anatomic surgical resection is associated with an improvement in overall and disease-free survival compared to nonanatomic resection. Anatomic resection is the preferred option in patients with recurrent hepatic colorectal metastases who are candidates for surgery.

*p=0.03