Detailed Abstract
[E-poster - Liver (Liver Disease/Surgery)]
[EP 027] Two-stage and one-stage parenchyma sparing liver surgical strategies in resection of colorectal liver metastases. Case-control study in Ukraine.
Anton BURLAKA1, Mykytyuk ARTEM1, Veronika ROZHKOVA1, Andrii BEZNOSENKO1
1Department of Hepatobiliary and Pancreatic Surgery, National Cancer Institute, Ukraine
Background : According to Ukrainian National Cancer Registry, colorectal liver metastases (CLRM) diagnosed in more than a half of colorectal cancer patients, and in 95 % of cases it leads to the cancer-specific death. Two-stage hepatectomy (TSH) with portal vein embolization (PVE) is a strategy introduced to face a high tumor burden of colorectal liver metastases (CLRM) and insufficient future liver remnant FLR. This retrospective study aimed to analyse survival benefits of TSH for bilobar CLRM in state specialised oncological centre.
Methods : The retrospective analysis of 1340 patients with CLRM cases using prospectively collected patient data from the National Cancer Institute Registry, collected between Jan/01/2000 and Dec/01/2023 was conducted. The TSH group (n = 45) was compared to parenchyma sparing one-stage (OSH) group (n = 60). Surgical and oncological outcomes comparison was done with case-control matching. OSH inclusion criteria were number of bilobar (bilateral) metastases (≥ 15) with spreading withing ≥ 4 anatomical liver segments. Patients in the comparison groups were stratified by stage, location of the primary tumor, metastatic burden and chemotherapy lines.
Results : The 90-day severe morbidity and mortality rates were 8.8% and 0% vs 40% and 6.6% after first and second stages in the TSH group respectively. Whereas in OSH 90-day severe morbidity was 31.6% with 0% mortality. There wasn’t statistical differences in 5-year overall survival rates (OS) between cohorts of the patients with OSH and TSH 48 ± 8% and 41 ± 12 % respectively, p = 0,67. Cumulative 5-year disease-free survival (DSF) for OSH and TSH groups was 31 ± 7% and 21 ± 5% respectively (p = 0,04). While 31.1% of TSH group who couldn’t complete second surgical appeared to be in drop-out cohort and didn’t survive the 5-year.
Conclusions : Parenchyma sparing one-stage liver surgery still has oncological advantages over two-stage resections for bilateral colorectal cancer metastases.
Methods : The retrospective analysis of 1340 patients with CLRM cases using prospectively collected patient data from the National Cancer Institute Registry, collected between Jan/01/2000 and Dec/01/2023 was conducted. The TSH group (n = 45) was compared to parenchyma sparing one-stage (OSH) group (n = 60). Surgical and oncological outcomes comparison was done with case-control matching. OSH inclusion criteria were number of bilobar (bilateral) metastases (≥ 15) with spreading withing ≥ 4 anatomical liver segments. Patients in the comparison groups were stratified by stage, location of the primary tumor, metastatic burden and chemotherapy lines.
Results : The 90-day severe morbidity and mortality rates were 8.8% and 0% vs 40% and 6.6% after first and second stages in the TSH group respectively. Whereas in OSH 90-day severe morbidity was 31.6% with 0% mortality. There wasn’t statistical differences in 5-year overall survival rates (OS) between cohorts of the patients with OSH and TSH 48 ± 8% and 41 ± 12 % respectively, p = 0,67. Cumulative 5-year disease-free survival (DSF) for OSH and TSH groups was 31 ± 7% and 21 ± 5% respectively (p = 0,04). While 31.1% of TSH group who couldn’t complete second surgical appeared to be in drop-out cohort and didn’t survive the 5-year.
Conclusions : Parenchyma sparing one-stage liver surgery still has oncological advantages over two-stage resections for bilateral colorectal cancer metastases.
SESSION
E-poster
E-Session 03/21 ALL DAY