Surgical resection is the only potentially curative strategy in the treatment of patients with colorectal liver metastases (CLM). Unfortunately, only about 10%–15% of patients are candidates for resection. Preoperative chemotherapy aims to increase the number of patients that may be eligible for liver resection by downsizing liver metastases. For patients with unresectable, chemotherapy refractory CLM the available treatment options are limited. Selective interarterial radiation therapy (SIRT) is one of the most promising treatment options for this group of patients. Although only a small number of these patients have been reported as becoming candidates for potentially curative hepatic resection following sufficient reduction in the volume of liver metastases, the question arises regarding the safety of liver resection in these patients. We report a case of a patient who presented unresectable liver relapse of CLM after previous right hepatectomy. He underwent SIRT which resulted in downsizing of the liver metastases making the patient candidate for left lateral sectionectomy. He underwent the redo hepatectomy without any complications. To the best of our knowledge, this is the first reported case of redo hepatectomy after SIRT for CLM. 1. Introduction Colorectal cancer (CRC) is the third leading cause of cancer-related death [1]. The liver is the most common site of metastatic spread in colorectal cancer (CRC). Approximately half of patients experience liver metastases during the course of their disease [2, 3]. Liver metastases from colorectal cancer are the main cause of morbidity and mortality among this patient group [4]. Liver resection has been established as the treatment of choice for these patients, and with the appropriate selection of patients 5-year survival rates approach 35% to 40% [5, 6]. Instead, the median survival for nonsurgically treated colorectal metastases ranges from 5.7 to 19 months and for patients receiving no treatment average survival is just 7.4 months [7, 8]. Despite surgical advances, only 10% to 15% of patients have resectable liver disease at presentation [9, 10]. Preoperative chemotherapy has been introduced to increase the number of patients that may be eligible for liver resection by downsizing liver metastases [11]. Unfortunately, a large proportion of patients with unresectable CLM will experience disease progression during the course of neoadjuvant chemotherapy. For these patients, the available treatment options are limited. Radioembolization (RE) or Selective interarterial radiation therapy (SIRT) is emerging
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