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Eur J Surg Oncol. 2018 Jan;44(1):122-129. doi: 10.1016/j.ejso.2017.11.006. Epub 2017 Nov 24.

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

Author information

1
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
2
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Hepatobiliary-Pancreatic Surgery Division, Department of Digestive Surgery, Toranomon Hospital, Tokyo, Japan.
3
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: jvauthey@mdanderson.org.

Abstract

BACKGROUND:

Increasingly, 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.

METHODS:

The 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.

RESULTS:

A 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).

CONCLUSIONS:

Tumor distribution may not affect the curability of surgery for multiple CLM. Liver resection would be justified for selected patients with bilobar CLM.

KEYWORDS:

Bilobar; Colorectal liver metastases; Liver resection; Overall survival; Recurrence-free survival

PMID:
29208318
PMCID:
PMC5742306
DOI:
10.1016/j.ejso.2017.11.006
[Indexed for MEDLINE]
Free PMC Article

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