Liver resection is justified for patients with bilateral multiple colorectal liver metastases: A propensity-score-matched analysis

Publication date: January 2018
Source:European Journal of Surgical Oncology, Volume 44, Issue 1
Author(s): Kiyohiko Omichi, Junichi Shindoh, Jordan M. Cloyd, Takashi Mizuno, Yun Shin Chun, Claudius Conrad, Thomas A. Aloia, Ching-Wei D. Tzeng, Jean-Nicolas Vauthey
BackgroundIncreasingly, patients with multiple colorectal liver metastases (CLM) are surgically treated. Some studies have shown that patients with bilobar and unilobar multiple CLM have similar outcomes, but other have shown that patients with bilobar CLM have worse outcomes after resection. We aimed to compare clinical outcomes of surgical treatment of bilobar and unilobar CLM using propensity score matching.MethodsThe single-institution study included patients who underwent hepatectomy for ≥3 histologically confirmed CLM during 1998–2014. Clinicopathologic characteristics and long-term outcomes were compared between patients with bilobar and unilobar CLM in a propensity-score-adjusted cohort.ResultsA total of 473 patients met the inclusion criteria, 271 (57%) with bilobar and 202 (43%) with unilobar CLM. In the propensity-score-matched population (bilobar, 170; unilobar, 170), no differences were observed according to the distribution of CLM except for a greater frequency of concomitant ablation, and R1 resection in the bilobar group. There was no difference between the bilobar and unilobar groups in 5-year overall survival rates (46% and 49%, respectively; P = 0.740) or 3-year recurrence-free survival rates (21% and 24%, respectively; P = 0.674).ConclusionsTumor distribution may not affect the curability of surgery for multiple CLM. Liver resection would be justified for selected patients with bilobar CLM.



http://ift.tt/2zh1L1m