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Multicenter Study
. 2022 May;36(5):3374-3381.
doi: 10.1007/s00464-021-08655-z. Epub 2021 Aug 30.

Long-term oncological outcomes after laparoscopic parenchyma-sparing redo liver resections for patients with metastatic colorectal cancer: a European multi-center study

Leonid Barkhatov  1   2   3 , Davit L Aghayan  4   5 , Vincenzo Scuderi  6 , Federica Cipriani  7 , Åsmund A Fretland  4   5   8 , Airazat M Kazaryan  4   9 , Francesca Ratti  7 , Thomas Armstrong  10 , Andrea Belli  11 , Ibrahim Dagher  12   13 , Giulio Belli  14 , Luca Aldrighetti  7   15 , Mohammad Abu Hilal  10   16 , Roberto I Troisi  17 , Bjørn Edwin  4   5   8
Affiliations
Multicenter Study

Long-term oncological outcomes after laparoscopic parenchyma-sparing redo liver resections for patients with metastatic colorectal cancer: a European multi-center study

Leonid Barkhatov et al. Surg Endosc. 2022 May.

Abstract

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.

Keywords: Colorectal liver metastases; Laparoscopic liver surgery; Parenchyma-sparing liver resections; Redo liver resections.

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Conflict of interest statement

Leonid Barkhatov, Davit L. Aghayan, Vincenzo Scuderi, Federica Cipriani, Åsmund A. Fretland, Airazat M. Kazaryan, Francesca Ratti, Thomas Armstrong, Andrea Belli, Ibrahim Dagher, Giulio Belli, Luca Aldrighetti, Mohammad Abu Hilal, Roberto I. Troisi, and Bjørn Edwin have no conflict of interest or financial ties to disclose.

Figures

Fig. 1
Fig. 1
Overall survival for the total cohort, n = 762 patients
Fig. 2
Fig. 2
Procedure-related overall survival for the first (1), second (2), third (3), and fourth (4) LLR. Survival has been calculated from the time of actual liver resection
Fig. 3
Fig. 3
Overall survival for patients with: 1—one LLR without liver recurrence; 2—only one redo LLR; 3—two or three redo LLR; 4—one LLR and no surgical treatment for liver recurrence. Survival has been calculated from the time of the first liver resection
See this image and copyright information in PMC

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