Parenchymal-Sparing Hepatectomy Does Not Increase Intrahepatic Recurrence in Patients with Advanced Colorectal Liver Metastases View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-05-20

AUTHORS

Masaru Matsumura, Yoshihiro Mise, Akio Saiura, Yosuke Inoue, Takeaki Ishizawa, Hirofumi Ichida, Ryota Matsuki, Masayuki Tanaka, Yoshinori Takeda, Yu Takahashi

ABSTRACT

BackgroundProphylactic impact of major hepatectomy (MH) on liver recurrence has yet to be clarified in patients with advanced colorectal liver metastases (CLMs).MethodsIn our institute, parenchymal-sparing hepatectomy (PSH) is a standard procedure for CLMs consistently throughout initial and repeat resection, and MH is selected only in cases in which CLMs are close to major Glisson’s pedicles. We reviewed 145 patients who underwent curative hepatectomy for advanced CLMs (≥4 nodules and ≤50 mm in size) from 1999 to 2012. Surgical outcomes and survival were compared between patients who underwent PSH and MH.ResultsPSH was performed in 113 patients (77.9 %) and MH in 32 (22.1 %) patients with advanced CLMs. Tumor characteristics and short-term outcomes did not differ between the 2 groups. Incidence of positive tumor margin (8.8 % in PSH vs 9.4 % in MH; p = .927) and rates of liver-only recurrence (43.4 % in PSH and 50.0 % in MH; p = .505) did not differ. No significant differences were found in 5-year overall survival (37.0 % in PSH vs 29.4 % in MH, p = .473), recurrence-free survival (7.6 vs 6.8 %, p = .597), and liver recurrence-free survival (21.0 vs 21.3 %, p = .691). A total of 65 patients had liver-only recurrence, for which repeat hepatectomy was performed in 81.5 % (53 of 65) following our parenchymal-sparing approach.ConclusionsIn patients with advanced CLM, PSH does not increase positive surgical margin or liver recurrence in comparison with MH. A parenchymal-sparing approach offers a high rate of repeat resection for liver recurrence (salvageability). More... »

PAGES

3718-3726

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    http://scigraph.springernature.com/pub.10.1245/s10434-016-5278-0

    DOI

    http://dx.doi.org/10.1245/s10434-016-5278-0

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1004294834

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/27207097


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        "description": "BackgroundProphylactic impact of major hepatectomy (MH) on liver recurrence has yet to be clarified in patients with advanced colorectal liver metastases (CLMs).MethodsIn our institute, parenchymal-sparing hepatectomy (PSH) is a standard procedure for CLMs consistently throughout initial and repeat resection, and MH is selected only in cases in which CLMs are close to major Glisson\u2019s pedicles. We reviewed 145 patients who underwent curative hepatectomy for advanced CLMs (\u22654 nodules and \u226450\u00a0mm in size) from 1999 to 2012. Surgical outcomes and survival were compared between patients who underwent PSH and MH.ResultsPSH was performed in 113 patients (77.9\u00a0%) and MH in 32 (22.1\u00a0%) patients with advanced CLMs. Tumor characteristics and short-term outcomes did not differ between the 2 groups. Incidence of positive tumor margin (8.8\u00a0% in PSH vs 9.4\u00a0% in MH; p\u00a0=\u00a0.927) and rates of liver-only recurrence (43.4\u00a0% in PSH and 50.0\u00a0% in MH; p\u00a0=\u00a0.505) did not differ. No significant differences were found in 5-year overall survival (37.0\u00a0% in PSH vs 29.4\u00a0% in MH, p\u00a0=\u00a0.473), recurrence-free survival (7.6 vs 6.8\u00a0%, p\u00a0=\u00a0.597), and liver recurrence-free survival (21.0 vs 21.3\u00a0%, p\u00a0=\u00a0.691). A total of 65 patients had liver-only recurrence, for which repeat hepatectomy was performed in 81.5\u00a0% (53 of 65) following our parenchymal-sparing approach.ConclusionsIn patients with advanced CLM, PSH does not increase positive surgical margin or liver recurrence in comparison with MH. A parenchymal-sparing approach offers a high rate of repeat resection for liver recurrence (salvageability).", 
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