BACKGROUND: This study aimed to compare the perioperative outcomes of liver-first (LFS) and classical (CS) strategy for the management of synchronous colorectal liver metastases (sCRLM). METHOD: A literature search was performed in PubMed, Scopus, and Cochrane databases, in accordance with the PRISMA guidelines. The odds ratio, weighted mean difference, and 95% confidence interval were evaluated by means of the random-effects model. RESULTS: Ten articles met the inclusion criteria, incorporating 3656 patients. Patients in the LFS group reported increased size of sCRLM and a higher rate of major hepatectomies. This study reveals comparable overall survival and disease-free survival at 1, 3, and 5 years postoperatively between the two strategies. Moreover, the mean operative time, length of hospital stay, the incidence of severe complications, and the 30-day and 90-day mortality were similar between the two groups. The mean intraoperative blood loss was significantly increased in the LFS group. CONCLUSION: These outcomes suggest that both approaches are feasible and safe. Given the lack of randomized clinical trials, this meta-analysis represents the best currently available evidence. However, the results should be treated with caution given the small number of the included studies. Randomized trials comparing LFS to CS are necessary to further evaluate their outcomes.
BACKGROUND: This study aimed to compare the perioperative outcomes of liver-first (LFS) and classical (CS) strategy for the management of synchronous colorectal liver metastases (sCRLM). METHOD: A literature search was performed in PubMed, Scopus, and Cochrane databases, in accordance with the PRISMA guidelines. The odds ratio, weighted mean difference, and 95% confidence interval were evaluated by means of the random-effects model. RESULTS: Ten articles met the inclusion criteria, incorporating 3656 patients. Patients in the LFS group reported increased size of sCRLM and a higher rate of major hepatectomies. This study reveals comparable overall survival and disease-free survival at 1, 3, and 5 years postoperatively between the two strategies. Moreover, the mean operative time, length of hospital stay, the incidence of severe complications, and the 30-day and 90-day mortality were similar between the two groups. The mean intraoperative blood loss was significantly increased in the LFS group. CONCLUSION: These outcomes suggest that both approaches are feasible and safe. Given the lack of randomized clinical trials, this meta-analysis represents the best currently available evidence. However, the results should be treated with caution given the small number of the included studies. Randomized trials comparing LFS to CS are necessary to further evaluate their outcomes.
Authors: Skye C Mayo; Carlo Pulitano; Hugo Marques; Jorge Lamelas; Christopher L Wolfgang; Wassila de Saussure; Michael A Choti; Isabelle Gindrat; Luca Aldrighetti; Eduardo Barrosso; Gilles Mentha; Timothy M Pawlik Journal: J Am Coll Surg Date: 2013-02-21 Impact factor: 6.113
Authors: Christian Sturesson; Valentinus T Valdimarsson; Erik Blomstrand; Sam Eriksson; Jan H Nilsson; Ingvar Syk; Gert Lindell Journal: HPB (Oxford) Date: 2016-11-09 Impact factor: 3.647
Authors: René Adam; Aimery de Gramont; Joan Figueras; Norihiro Kokudo; Francis Kunstlinger; Evelyne Loyer; Graeme Poston; Philippe Rougier; Laura Rubbia-Brandt; Alberto Sobrero; Catherine Teh; Sabine Tejpar; Eric Van Cutsem; Jean-Nicolas Vauthey; Lars Påhlman Journal: Cancer Treat Rev Date: 2015-06-30 Impact factor: 12.111
Authors: Vincent W T Lam; Jerome M Laurence; Tony Pang; Emma Johnston; Michael J Hollands; Henry C C Pleass; Arthur J Richardson Journal: HPB (Oxford) Date: 2013-03-19 Impact factor: 3.647
Authors: Mauro Podda; Patricia Sylla; Gianluca Baiocchi; Michel Adamina; Vanni Agnoletti; Ferdinando Agresta; Luca Ansaloni; Alberto Arezzo; Nicola Avenia; Walter Biffl; Antonio Biondi; Simona Bui; Fabio C Campanile; Paolo Carcoforo; Claudia Commisso; Antonio Crucitti; Nicola De'Angelis; Gian Luigi De'Angelis; Massimo De Filippo; Belinda De Simone; Salomone Di Saverio; Giorgio Ercolani; Gustavo P Fraga; Francesco Gabrielli; Federica Gaiani; Mario Guerrieri; Angelo Guttadauro; Yoram Kluger; Ari K Leppaniemi; Andrea Loffredo; Tiziana Meschi; Ernest E Moore; Monica Ortenzi; Francesco Pata; Dario Parini; Adolfo Pisanu; Gilberto Poggioli; Andrea Polistena; Alessandro Puzziello; Fabio Rondelli; Massimo Sartelli; Neil Smart; Michael E Sugrue; Patricia Tejedor; Marco Vacante; Federico Coccolini; Justin Davies; Fausto Catena Journal: World J Emerg Surg Date: 2021-07-02 Impact factor: 5.469
Authors: Felice Giuliante; Luca Viganò; Agostino M De Rose; Darius F Mirza; Réal Lapointe; Gernot Kaiser; Eduardo Barroso; Alessandro Ferrero; Helena Isoniemi; Santiago Lopez-Ben; Irinel Popescu; Jean-Francois Ouellet; Catherine Hubert; Jean-Marc Regimbeau; Jen-Kou Lin; Oleg G Skipenko; Francesco Ardito; René Adam Journal: Ann Surg Oncol Date: 2021-07-01 Impact factor: 5.344