Long-term oncological outcomes after laparoscopic parenchyma-sparing redo liver resections for patients with metastatic colorectal cancer: a European multi-center study.
Colorectal liver metastases
Laparoscopic liver surgery
Parenchyma-sparing liver resections
Redo liver resections
Journal
Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653
Informations de publication
Date de publication:
05 2022
05 2022
Historique:
received:
12
01
2021
accepted:
16
07
2021
pubmed:
1
9
2021
medline:
15
4
2022
entrez:
31
8
2021
Statut:
ppublish
Résumé
Laparoscopic redo resections for colorectal metastases are poorly investigated. This study aims to explore long-term results after second, third, and fourth resections. Prospectively updated databases of primary and redo laparoscopic liver resections in six European HPB centers were analyzed. Procedure-related overall survival after first, second, third, and fourth resections were evaluated. Furthermore, patients without liver recurrence after first liver resection were compared to those with one redo, two or three redo, and patients with palliative treatment for liver recurrence after first laparoscopic liver surgery. Survival was calculated both from the date of the first liver resection and from the date of the actual liver resection. In total, 837 laparoscopic primary and redo liver resections performed in 762 patients were included (630 primary, 172 first redo, 29 second redo, and 6 third redo). Patients were bunched into four groups: Group 1-without hepatic recurrence after primary liver resection (n = 441); Group 2-with liver recurrence who underwent only one laparoscopic redo resection (n = 154); Group 3-with liver recurrence who underwent two laparoscopic redo resections (n = 29); Group 4-with liver recurrence who have not been found suitable for redo resections (n = 138). No significant difference has been found between the groups in terms of baseline characteristics and surgical outcomes. Rate of positive resection margin was higher in the group with palliative recurrence (group 4). Five-year survival calculated from the first liver resection was 67%, 62%, 84%, and 7% for group 1, 2, 3, and 4, respectively. Procedure-specific 5-year overall survival was 50% after primary laparoscopic liver resection, 52% after the 1st reoperation, 52% after the 2nd, and 40% after the 3rd reoperation made laparoscopic. Multiple redo recurrences can be performed laparoscopically with good long-term results. Liver recurrence does not aggravate prognosis as long as the patient is suitable for reoperation.
Sections du résumé
BACKGROUND
Laparoscopic redo resections for colorectal metastases are poorly investigated. This study aims to explore long-term results after second, third, and fourth resections.
MATERIAL AND METHODS
Prospectively updated databases of primary and redo laparoscopic liver resections in six European HPB centers were analyzed. Procedure-related overall survival after first, second, third, and fourth resections were evaluated. Furthermore, patients without liver recurrence after first liver resection were compared to those with one redo, two or three redo, and patients with palliative treatment for liver recurrence after first laparoscopic liver surgery. Survival was calculated both from the date of the first liver resection and from the date of the actual liver resection. In total, 837 laparoscopic primary and redo liver resections performed in 762 patients were included (630 primary, 172 first redo, 29 second redo, and 6 third redo). Patients were bunched into four groups: Group 1-without hepatic recurrence after primary liver resection (n = 441); Group 2-with liver recurrence who underwent only one laparoscopic redo resection (n = 154); Group 3-with liver recurrence who underwent two laparoscopic redo resections (n = 29); Group 4-with liver recurrence who have not been found suitable for redo resections (n = 138).
RESULTS
No significant difference has been found between the groups in terms of baseline characteristics and surgical outcomes. Rate of positive resection margin was higher in the group with palliative recurrence (group 4). Five-year survival calculated from the first liver resection was 67%, 62%, 84%, and 7% for group 1, 2, 3, and 4, respectively. Procedure-specific 5-year overall survival was 50% after primary laparoscopic liver resection, 52% after the 1st reoperation, 52% after the 2nd, and 40% after the 3rd reoperation made laparoscopic.
CONCLUSIONS
Multiple redo recurrences can be performed laparoscopically with good long-term results. Liver recurrence does not aggravate prognosis as long as the patient is suitable for reoperation.
Identifiants
pubmed: 34462867
doi: 10.1007/s00464-021-08655-z
pii: 10.1007/s00464-021-08655-z
pmc: PMC9001231
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
3374-3381Informations de copyright
© 2021. The Author(s).
Références
Langenbecks Arch Surg. 2012 Mar;397(3):383-95
pubmed: 22089696
Br J Surg. 2019 Sep;106(10):1372-1380
pubmed: 31322735
Lancet. 2000 Jan 29;355(9201):395-9
pubmed: 10665570
Gastroenterol Res Pract. 2012;2012:568214
pubmed: 22973305
J Am Coll Surg. 2011 Feb;212(2):171-9
pubmed: 21276531
Br J Surg. 1999 Feb;86(2):158-69
pubmed: 10100781
J Am Coll Surg. 2015 Aug;221(2):265-72
pubmed: 25899733
Surgery. 2015 Jun;157(6):1046-54
pubmed: 25835216
Ann Intern Med. 2021 Feb;174(2):175-182
pubmed: 33197213
Ann Surg. 1979 Apr;189(4):496-502
pubmed: 443905
Oncotarget. 2016 Dec 20;7(51):84544-84555
pubmed: 27811369
Arch Surg. 2007 Jun;142(6):526-31; discussion 531-2
pubmed: 17576888
HPB (Oxford). 2014 Feb;16(2):157-63
pubmed: 23530978
J Am Coll Surg. 2015 Oct;221(4):e65-73
pubmed: 26272013
World J Surg. 2018 Apr;42(4):1171-1179
pubmed: 28948336
HPB (Oxford). 2017 Jun;19(6):491-497
pubmed: 28347640
Clin Epidemiol. 2012;4:283-301
pubmed: 23152705
World J Surg. 2014 Dec;38(12):3175-80
pubmed: 25138071
Ann Surg. 2016 May;263(5):e68-72
pubmed: 26641255
Clin Exp Metastasis. 2007;24(1):39-48
pubmed: 17260102
J Hepatobiliary Pancreat Surg. 2006;13(2):149-54
pubmed: 16547677
Ann Surg. 2010 Dec;252(6):1005-12
pubmed: 21107111
Ann Surg. 2008 Jan;247(1):125-35
pubmed: 18156932
Ann Surg Oncol. 2014 Dec;21(13):4293-9
pubmed: 24962942
Medicine (Baltimore). 2015 Oct;94(42):e1786
pubmed: 26496309
Nat Clin Pract Gastroenterol Hepatol. 2008 Nov;5(11):648-54
pubmed: 18762794
Radiol Oncol. 2017 Nov 01;52(1):36-41
pubmed: 29520204
Am J Surg. 2013 Jan;205(1):8-14
pubmed: 23245433
Surg Endosc. 2015 Aug;29(8):2410-7
pubmed: 25391984
Ann Surg. 2018 Feb;267(2):199-207
pubmed: 28657937
Ann Surg. 2016 Apr;263(4):761-77
pubmed: 26700223
Eur J Surg Oncol. 2014 May;40(5):536-544
pubmed: 24555996
Br J Surg. 2006 Apr;93(4):457-64
pubmed: 16555242
J Hepatobiliary Pancreat Surg. 2005;12(4):298-303
pubmed: 16133696
Am J Surg. 2009 Aug;198(2):173-7
pubmed: 19268902