Detailed Abstract
[Liver Oral Presentation 2 - Liver (Liver Disease/Surgery)]
[LV OP 2-S1] Minimally Invasive Simultaneous Resection of Colorectal Liver Metastasis: Is It Worth Doing? - a Propensity Matched Analysis
Janesh MURUGAN 1, Na Reum KIM 1, Gi Hong CHOI 1
1 HPB Surgery, Severance Hospital, REPUBLIC OF KOREA
Background : The safety and oncological outcomes of minimally invasive (MIS) simultaneous resection of colorectal liver metastasis (CRLM) with primary colorectal cancer (CRC) are investigated in this study.
Methods : Patients undergoing simultaneous resections between 2008 and 2021 were retrospectively analysed and grouped into MIS and Open Surgery Groups. Propensity Matching (PSM) matched the groups for differences in size, number and location of liver lesions; liver surgery done: neoadjuvant chemotherapy received and preoperative CEA.
Results : 755 patients (152 - MIS: 603 -Open) underwent simultaneous resections. The liver lesions in the MIS group were fewer (Median - 1 vs 3; p <0.001) and smaller ( median, largest lesion 1.5 vs 2.1 cm: p <0.001) with less bilobar distribution. ( 21% vs 52.7%, P < 0.001). The open group had higher CEA levels ( 5.80 vs 4.60, P-0.002) and substantially more complex liver surgery. After PSM, the MIS and open groups had 103 and 109 patients. The median operating time and complication rates were similar, but the MIS group had less blood loss ( 200 vs 500 ml; P<0.001) and shorter hospital stays ( 8 vs 11 days; p<0.001). R-Plus resection rates (14.6% vs 11%, p-0.438), Recurrence rates ( 63.1% vs 68.8%, p-0.381) and RFS ( Median 16 vs 13 months, 5-year RFS 33.7% vs 27.6%; P-0.320) were similar. Though median OS was not reached, the MIS group had better 5-year OS (91% vs 72%, p-0.002)
Conclusions : MIS has better short-term outcomes with similar oncological outcomes in simultaneous CRLM resections and should be offered when expertise is available.
Methods : Patients undergoing simultaneous resections between 2008 and 2021 were retrospectively analysed and grouped into MIS and Open Surgery Groups. Propensity Matching (PSM) matched the groups for differences in size, number and location of liver lesions; liver surgery done: neoadjuvant chemotherapy received and preoperative CEA.
Results : 755 patients (152 - MIS: 603 -Open) underwent simultaneous resections. The liver lesions in the MIS group were fewer (Median - 1 vs 3; p <0.001) and smaller ( median, largest lesion 1.5 vs 2.1 cm: p <0.001) with less bilobar distribution. ( 21% vs 52.7%, P < 0.001). The open group had higher CEA levels ( 5.80 vs 4.60, P-0.002) and substantially more complex liver surgery. After PSM, the MIS and open groups had 103 and 109 patients. The median operating time and complication rates were similar, but the MIS group had less blood loss ( 200 vs 500 ml; P<0.001) and shorter hospital stays ( 8 vs 11 days; p<0.001). R-Plus resection rates (14.6% vs 11%, p-0.438), Recurrence rates ( 63.1% vs 68.8%, p-0.381) and RFS ( Median 16 vs 13 months, 5-year RFS 33.7% vs 27.6%; P-0.320) were similar. Though median OS was not reached, the MIS group had better 5-year OS (91% vs 72%, p-0.002)
Conclusions : MIS has better short-term outcomes with similar oncological outcomes in simultaneous CRLM resections and should be offered when expertise is available.
SESSION
Liver Oral Presentation 2
Room F 3/22/2024 4:30 PM - 5:30 PM