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

• Published in: Surgery Vol. 157; no. 6; pp. 1065 - 1072
• Main Authors: Hasegawa, Yasushi, MD, Nitta, Hiroyuki, MD, Sasaki, Akira, MD, Takahara, Takeshi, MD, Itabashi, Hidenori, MD, Katagiri, Hirokatsu, MD, Otsuka, Koki, MD, Nishizuka, Satoshi, MD, PhD, Wakabayashi, Go, MD, PhD, FACS
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-06-2015
• Subjects: 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; Surgery; Survival Analysis; Survivors; Time Factors; Treatment Outcome; Young Adult; Japan
• ISSN: 0039-6060; 1532-7361
• DOI: 10.1016/j.surg.2015.01.017

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.