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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 11/2016

01-10-2016 | Hepatobiliary Tumors

Parenchymal-Sparing Hepatectomy Does Not Increase Intrahepatic Recurrence in Patients with Advanced Colorectal Liver Metastases

Authors: Masaru Matsumura, MD, Yoshihiro Mise, MD, PhD, Akio Saiura, MD, PhD, Yosuke Inoue, MD, PhD, Takeaki Ishizawa, MD, PhD, Hirofumi Ichida, MD, PhD, Ryota Matsuki, MD, Masayuki Tanaka, MD, PhD, Yoshinori Takeda, MD, Yu Takahashi, MD, PhD

Published in: Annals of Surgical Oncology | Issue 11/2016

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Abstract

Background

Prophylactic impact of major hepatectomy (MH) on liver recurrence has yet to be clarified in patients with advanced colorectal liver metastases (CLMs).

Methods

In our institute, parenchymal-sparing hepatectomy (PSH) is a standard procedure for CLMs consistently throughout initial and repeat resection, and MH is selected only in cases in which CLMs are close to major Glisson’s pedicles. We reviewed 145 patients who underwent curative hepatectomy for advanced CLMs (≥4 nodules and ≤50 mm in size) from 1999 to 2012. Surgical outcomes and survival were compared between patients who underwent PSH and MH.

Results

PSH was performed in 113 patients (77.9 %) and MH in 32 (22.1 %) patients with advanced CLMs. Tumor characteristics and short-term outcomes did not differ between the 2 groups. Incidence of positive tumor margin (8.8 % in PSH vs 9.4 % in MH; p = .927) and rates of liver-only recurrence (43.4 % in PSH and 50.0 % in MH; p = .505) did not differ. No significant differences were found in 5-year overall survival (37.0 % in PSH vs 29.4 % in MH, p = .473), recurrence-free survival (7.6 vs 6.8 %, p = .597), and liver recurrence-free survival (21.0 vs 21.3 %, p = .691). A total of 65 patients had liver-only recurrence, for which repeat hepatectomy was performed in 81.5 % (53 of 65) following our parenchymal-sparing approach.

Conclusions

In patients with advanced CLM, PSH does not increase positive surgical margin or liver recurrence in comparison with MH. A parenchymal-sparing approach offers a high rate of repeat resection for liver recurrence (salvageability).
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Metadata
Title
Parenchymal-Sparing Hepatectomy Does Not Increase Intrahepatic Recurrence in Patients with Advanced Colorectal Liver Metastases
Authors
Masaru Matsumura, MD
Yoshihiro Mise, MD, PhD
Akio Saiura, MD, PhD
Yosuke Inoue, MD, PhD
Takeaki Ishizawa, MD, PhD
Hirofumi Ichida, MD, PhD
Ryota Matsuki, MD
Masayuki Tanaka, MD, PhD
Yoshinori Takeda, MD
Yu Takahashi, MD, PhD
Publication date
01-10-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 11/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5278-0

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