Long-term and perioperative outcomes of laparoscopic versus open liver resection for colorectal liver metastases with propensity score matching: a multi-institutional Japanese study

Toru Beppu¹, Go Wakabayashi², Kiyoshi Hasegawa³, Naoto Gotohda⁴, Toru Mizuguchi⁵, Yutaka Takahashi⁶, Fumitoshi Hirokawa⁷, Nobuhiko Taniai⁸, Manabu Watanabe⁹, Masato Katou¹⁰, Hiroaki Nagano¹¹, Goro Honda¹², Hideo Baba¹, Norihiro Kokudo³, Masaru Konishi⁴, Koichi Hirata⁵, Masakazu Yamamoto⁶, Kazuhisa Uchiyama⁷, Eiji Uchida⁸, Shinya Kusachi⁹, Keiichi Kubota¹⁰, Masaki Mori¹¹, Keiichi Takahashi¹², Ken Kikuchi¹³, Hiroaki Miyata¹⁴, Takeshi Takahara², Masafumi Nakamura¹⁵, Hironori Kaneko¹⁶, Hiroki Yamaue¹⁷, Masaru Miyazaki¹⁸, Tadahiro Takada¹⁹

Affiliations

¹ Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
² Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan.
³ Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
⁴ Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
⁵ Department of Surgery, Surgical Oncology and Science, Sapporo Medical University School of Medicine, Sapporo, Japan.
⁶ Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
⁷ Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan.
⁸ Department of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan.
⁹ Department of Surgery, Toho University Ohashi Medical Center, Tokyo, Japan.
¹⁰ Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan.
¹¹ Department of Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
¹² Department of Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan.
¹³ Medical Quality Management Center, Kumamoto University Hospital, Kumamoto, Japan.
¹⁴ Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
¹⁵ Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
¹⁶ Deparment of Surgery, Toho University Faculty of Medicine, Tokyo, Japan.
¹⁷ Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama, Japan.
¹⁸ Department of General Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
¹⁹ Japanese Society of Hepato-biliary-Pancreatic Surgery, Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.

PMID: 25902703
DOI: 10.1002/jhbp.261

Comparative Study

Long-term and perioperative outcomes of laparoscopic versus open liver resection for colorectal liver metastases with propensity score matching: a multi-institutional Japanese study

Toru Beppu et al. J Hepatobiliary Pancreat Sci. 2015 Oct.

. 2015 Oct;22(10):711-20.

doi: 10.1002/jhbp.261. Epub 2015 May 21.

Authors

Affiliations

¹ Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
² Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan.
³ Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
⁴ Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
⁵ Department of Surgery, Surgical Oncology and Science, Sapporo Medical University School of Medicine, Sapporo, Japan.
⁶ Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
⁷ Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan.
⁸ Department of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan.
⁹ Department of Surgery, Toho University Ohashi Medical Center, Tokyo, Japan.
¹⁰ Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan.
¹¹ Department of Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
¹² Department of Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan.
¹³ Medical Quality Management Center, Kumamoto University Hospital, Kumamoto, Japan.
¹⁴ Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
¹⁵ Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
¹⁶ Deparment of Surgery, Toho University Faculty of Medicine, Tokyo, Japan.
¹⁷ Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama, Japan.
¹⁸ Department of General Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
¹⁹ Japanese Society of Hepato-biliary-Pancreatic Surgery, Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.

PMID: 25902703
DOI: 10.1002/jhbp.261

Abstract

Background: The aim of the present study was to clarify the surgical outcome and long-term prognosis of laparoscopic liver resection (LLR) compared with conventional open liver resection (OLR) in patients with colorectal liver metastases (CRLM).

Methods: A one-to-two propensity score matching (PSM) analysis was applied. Covariates (P < 0.2) used for PSM estimation included preoperative levels of CEA and CA19-9; primary tumor differentiation; primary pathological lymph node metastasis; number, size, location, and distribution of CRLM; existence of extrahepatic metastasis; extent of hepatic resection; total bilirubin and prothrombin activity levels; and preoperative chemotherapy. Perioperative data and long-term survival were compared.

Results: From 2005 to 2010, 1,331 patients with hepatic resection for CRLM were enrolled. By PSM, 171 LLR and 342 OLR patients showed similar preoperative clinical characteristics. Median estimated blood loss (163 g vs 415 g, P < 0.001) and median postoperative hospital stay (12 days vs 14 days; P < 0.001) were significantly reduced in the LLR group. Morbidity and mortality were similar. Five-year rates of recurrence-free, overall, and disease-specific survival did not differ significantly. The R0 resection rate was similar.

Conclusions: In selected CRLM patients, LLR is strongly associated with lower blood loss and shorter hospital stay and has equivalent long-term survival comparable with OLR.

Keywords: Colorectal liver metastases; Laparoscopic liver resection; Open liver resection; Propensity score matched analysis.

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Comment in

Long-term outcomes and safety of laparoscopic liver resection surgery for hepatocellular carcinoma and metastatic colorectal cancer.
Geller DA, Tsung A. Geller DA, et al. J Hepatobiliary Pancreat Sci. 2015 Oct;22(10):728-30. doi: 10.1002/jhbp.278. Epub 2015 Aug 11. J Hepatobiliary Pancreat Sci. 2015. PMID: 26123552 No abstract available.

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Long-term and perioperative outcomes of laparoscopic versus open liver resection for colorectal liver metastases with propensity score matching: a multi-institutional Japanese study

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Long-term and perioperative outcomes of laparoscopic versus open liver resection for colorectal liver metastases with propensity score matching: a multi-institutional Japanese study

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Abstract

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