Long-term outcomes of laparoscopic versus open liver resection for liver metastases from colorectal cancer: A comparative analysis of 168 consecutive cases at a single center

Surgery. 2015 Jun;157(6):1065-72. doi: 10.1016/j.surg.2015.01.017. Epub 2015 Mar 16.

Abstract

Background: Laparoscopic liver resection for liver metastases from colorectal cancer (CRLM) is performed in a relatively small number of institutions. Its operative results have been reported to be comparable with that of open laparotomy; however, information on its oncologic outcomes is scarce. This study aimed to compare the long-term outcomes of laparoscopic hepatectomy (LH) and open hepatectomy (OH) to treat CRLM at a single institution.

Methods: We retrospectively reviewed data from 168 consecutive patients who underwent LH (n = 100) or OH (n = 68) for CRLM. The tumor characteristics, operative results, overall survival (OS) rate, recurrence-free survival (RFS) rate, and recurrence patterns were analyzed and compared. A previously published survival-predicting nomogram was applied to compare OS and RFS between the 2 patient groups.

Results: The largest tumor diameter and the number of tumors were significantly larger in the OH group than in the LH group; however, no differences in other tumor factors were observed between the 2 groups. When matched by the nomogram, OS and RFS remained comparable between the 2 groups in every examined stratum, not only for low-risk patients but also for those with high risk. The recurrence patterns also were similar (liver: 30.2% vs 26.8%, P = .72; lung: 22.6% vs 34.1%, P = .22; peritoneum: 7.6% vs 4.9%, P = .45).

Conclusion: The long-term outcomes of laparoscopic liver resection for CRLM were comparable with those of the open procedure in not only low-risk but also high-risk patients.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / secondary
  • Adenocarcinoma / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery
  • Databases, Factual
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Hepatectomy / methods*
  • Hepatectomy / mortality
  • Humans
  • Japan
  • Kaplan-Meier Estimate
  • Laparoscopy / methods
  • Laparoscopy / mortality*
  • Laparotomy / methods
  • Laparotomy / mortality*
  • Liver Neoplasms / mortality
  • Liver Neoplasms / secondary*
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Proportional Hazards Models
  • Regression Analysis
  • Retrospective Studies
  • Risk Assessment
  • Survival Analysis
  • Survivors
  • Time Factors
  • Treatment Outcome
  • Young Adult