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Comparative Study
. 2011 Mar;35(3):656-61.
doi: 10.1007/s00268-010-0890-9.

Anatomical versus nonanatomical resection of colorectal liver metastases: is there a difference in surgical and oncological outcome?

Zarina S Lalmahomed  1 , Ninos Ayez, Anne E M van der Pool, Joanne Verheij, Jan N M IJzermans, Cornelis Verhoef
Affiliations
Comparative Study

Anatomical versus nonanatomical resection of colorectal liver metastases: is there a difference in surgical and oncological outcome?

Zarina S Lalmahomed et al. World J Surg. 2011 Mar.

Abstract

Background: The increased use of neoadjuvant chemotherapy and minimally invasive therapies for recurrence in patients with colorectal liver metastases (CLM) makes a surgical strategy to save as much liver volume as possible pivotal. In this study, we determined the difference in morbidity and mortality and the patterns of recurrence and survival in patients with CLM treated with anatomical (AR) and nonanatomical liver resection (NAR).

Methods: From January 2000 to June 2008, patients with CLM who underwent a resection were included and divided into two groups: patients who underwent AR, and patients who underwent NAR. Patients who underwent simultaneous radiofrequency ablation in addition to surgery and patients with extrahepatic metastasis were excluded. Patient, tumor, and treatment data, as well as disease-free and overall survival (OS) were compared.

Results: Eighty-eight patients (44%) received AR and 113 patients (56%) underwent NAR. NAR were performed for significant smaller metastases (3 vs. 4 cm, P < 0.001). The Clinical Risk Score did not differ between the groups. After NAR, patients received significantly less blood transfusions (20% vs. 36%, P = 0.012), and the hospital stay was significantly shorter (7 vs. 8 days, P < 0.001). There were no significant differences in complications, positive resection margins, or recurrence. For the total study group, estimated 5-year disease-free and OS was 31 and 44%, respectively, with no difference between the groups.

Conclusions: Our study resulted in no significant difference in morbidity, mortality, recurrence rate, or survival according to resection type. NAR can be used as a save procedure to preserve liver parenchyma.

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Figures

Fig. 1
Fig. 1
Disease-free survival stratified by surgical procedure. Median DFS was 16.7 months in the AR group and 18.7 months in the NAR group. The 5-year DFS rate was 30 and 32%, respectively (P = 0.599)
Fig. 2
Fig. 2
Overall survival stratified by surgical procedure. Median OS was 49 months in the AR group and 47.2 months in the NAR group. The 5-year OS rate was 49 and 39%, respectively (P = 0.989)
See this image and copyright information in PMC

References

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