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Erschienen in: Surgical Endoscopy 12/2018

14.05.2018

Recurrence patterns after laparoscopic resection of colorectal liver metastases

verfasst von: Nicolas Tabchouri, Brice Gayet, Shinya Okumura, Gianfranco Donatelli, Marc Beaussier, Mostefa Bennamoun, Christophe Louvet, David Fuks

Erschienen in: Surgical Endoscopy | Ausgabe 12/2018

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Abstract

Background

The major issue after liver resection for colorectal liver metastases (CRLM) is the high incidence of recurrence. Unlike open liver resection (OLR), recurrence following laparoscopic liver resection (LLR) is not well documented. The aim of this study was to analyze recurrence patterns and treatment following LLR for CRLM.

Study design

All patients who underwent LLR for CRLM from 2000 to 2016 were reviewed. Patients who presented with recurrence were compared to those who did not. Recurrence-free survival (RFS), overall survival (OS), and risk of recurrence and survival prognostic factors were analyzed.

Results

Overall, 273 patients were included, of which 157 (57.5%) were treated for one liver metastasis (LM). Median follow-up was 41 (12–187) months and associated extrahepatic disease was present in 27% of patients (mainly pulmonary, 65%). After a median of 16 (3–151) months, 197 (72%) patients presented with recurrence. Recurrences were early (< 6 months) in 22.8% of cases, occured in a single site in 66% and were intrahepatic, extrahepatic, or both in 44, 30, and 26%, respectively. Recurrences were treated with surgery or chemotherapy only in 45 and 47%, respectively. 3-, 5-, and 10-year OS was 82, 71, and 43%, respectively. Independent risk factors for recurrence were node-positive primary tumor, extrahepatic disease before hepatectomy, and R1 resection.

Conclusion

LLR for CRLM does not seem to be associated with distinctive recurrence patterns. LLR for CRLM yielded satisfying RFS and OS and should therefore be considered whenever possible.
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Metadaten
Titel
Recurrence patterns after laparoscopic resection of colorectal liver metastases
verfasst von
Nicolas Tabchouri
Brice Gayet
Shinya Okumura
Gianfranco Donatelli
Marc Beaussier
Mostefa Bennamoun
Christophe Louvet
David Fuks
Publikationsdatum
14.05.2018
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 12/2018
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-018-6229-6

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