Nicolas Tabchouri1,2, Brice Gayet1, Shinya Okumura1, Gianfranco Donatelli1, Marc Beaussier1, Mostefa Bennamoun3, Christophe Louvet3, David Fuks4. 1. Department of Digestive Disease, Institut Mutualiste Montsouris, Université Paris Descartes, 42 Boulevard Jourdan, 75014, Paris, France. 2. Department of Digestive Surgery, Trousseau Hospital, Avenue de la République, 37170, Chambray-lès-Tours, France. 3. Department of Oncology, Institut Mutualiste Montsouris, 42 boulevard Jourdan, 75014, Paris, France. 4. Department of Digestive Disease, Institut Mutualiste Montsouris, Université Paris Descartes, 42 Boulevard Jourdan, 75014, Paris, France. david.fuks@imm.fr.
Abstract
BACKGROUND: The major issue after liver resection for colorectal liver metastases (CRLM) is the high incidence of recurrence. Unlike open liver resection (OLR), recurrence following laparoscopic liver resection (LLR) is not well documented. The aim of this study was to analyze recurrence patterns and treatment following LLR for CRLM. STUDY DESIGN: All patients who underwent LLR for CRLM from 2000 to 2016 were reviewed. Patients who presented with recurrence were compared to those who did not. Recurrence-free survival (RFS), overall survival (OS), and risk of recurrence and survival prognostic factors were analyzed. RESULTS: Overall, 273 patients were included, of which 157 (57.5%) were treated for one liver metastasis (LM). Median follow-up was 41 (12-187) months and associated extrahepatic disease was present in 27% of patients (mainly pulmonary, 65%). After a median of 16 (3-151) months, 197 (72%) patients presented with recurrence. Recurrences were early (< 6 months) in 22.8% of cases, occured in a single site in 66% and were intrahepatic, extrahepatic, or both in 44, 30, and 26%, respectively. Recurrences were treated with surgery or chemotherapy only in 45 and 47%, respectively. 3-, 5-, and 10-year OS was 82, 71, and 43%, respectively. Independent risk factors for recurrence were node-positive primary tumor, extrahepatic disease before hepatectomy, and R1 resection. CONCLUSION: LLR for CRLM does not seem to be associated with distinctive recurrence patterns. LLR for CRLM yielded satisfying RFS and OS and should therefore be considered whenever possible.
BACKGROUND: The major issue after liver resection for colorectal liver metastases (CRLM) is the high incidence of recurrence. Unlike open liver resection (OLR), recurrence following laparoscopic liver resection (LLR) is not well documented. The aim of this study was to analyze recurrence patterns and treatment following LLR for CRLM. STUDY DESIGN: All patients who underwent LLR for CRLM from 2000 to 2016 were reviewed. Patients who presented with recurrence were compared to those who did not. Recurrence-free survival (RFS), overall survival (OS), and risk of recurrence and survival prognostic factors were analyzed. RESULTS: Overall, 273 patients were included, of which 157 (57.5%) were treated for one liver metastasis (LM). Median follow-up was 41 (12-187) months and associated extrahepatic disease was present in 27% of patients (mainly pulmonary, 65%). After a median of 16 (3-151) months, 197 (72%) patients presented with recurrence. Recurrences were early (< 6 months) in 22.8% of cases, occured in a single site in 66% and were intrahepatic, extrahepatic, or both in 44, 30, and 26%, respectively. Recurrences were treated with surgery or chemotherapy only in 45 and 47%, respectively. 3-, 5-, and 10-year OS was 82, 71, and 43%, respectively. Independent risk factors for recurrence were node-positive primary tumor, extrahepatic disease before hepatectomy, and R1 resection. CONCLUSION: LLR for CRLM does not seem to be associated with distinctive recurrence patterns. LLR for CRLM yielded satisfying RFS and OS and should therefore be considered whenever possible.
Authors: R Adam; K Imai; C Castro Benitez; M-A Allard; E Vibert; A Sa Cunha; D Cherqui; H Baba; D Castaing Journal: Br J Surg Date: 2016-08-12 Impact factor: 6.939
Authors: J Hallet; A Sa Cunha; R Adam; D Goéré; P Bachellier; D Azoulay; A Ayav; E Grégoire; F Navarro; P Pessaux Journal: Br J Surg Date: 2016-06-16 Impact factor: 6.939
Authors: R Montalti; G Berardi; S Laurent; S Sebastiani; L Ferdinande; L J Libbrecht; P Smeets; A Brescia; X Rogiers; B de Hemptinne; K Geboes; R I Troisi Journal: Eur J Surg Oncol Date: 2014-02-02 Impact factor: 4.424
Authors: Andrew A Gumbs; Roland Croner; Eric Lorenz; Andrea Benedetti Cacciaguerra; Tzu-Jung Tsai; Lee Starker; Joe Flanagan; Ng Jing Yu; Elie Chouillard; Mohammad Abu Hilal Journal: Cancers (Basel) Date: 2022-08-29 Impact factor: 6.575