Parenchymal-sparing hepatectomy for colorectal liver metastases reduces postoperative morbidity while maintaining equivalent oncologic outcomes compared to non-parenchymal-sparing resection

• Published in: Surgical oncology 2021-09, Vol.38, p.101631-101631, Article 101631
• Main Authors: Andreou, Andreas, Gloor, Severin, Inglin, Julia, Di Pietro Martinelli, Claudine, Banz, Vanessa, Lachenmayer, Anja, Kim-Fuchs, Corina, Candinas, Daniel, Beldi, Guido
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Chemotherapy; Colorectal liver metastases; Colorectal Neoplasms - mortality; Colorectal Neoplasms - pathology; Colorectal Neoplasms - surgery; Complications; Embolization; Equivalence; Female; Follow-Up Studies; Hepatectomy; Hepatectomy - mortality; Humans; Interdisciplinary aspects; Laparoscopy; Liver; Liver Neoplasms - mortality; Liver Neoplasms - pathology; Liver Neoplasms - surgery; Magnetic resonance imaging; Male; Metastases; Metastasis; Middle Aged; Morbidity; Mortality; Multivariate analysis; Neoplasm Recurrence, Local - mortality; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - surgery; Organ Sparing Treatments - mortality; Parenchymal Tissue - pathology; Parenchymal Tissue - surgery; Parenchymal-sparing resection; Patients; Postoperative Complications - epidemiology; Postoperative Complications - mortality; Postoperative Complications - pathology; Postoperative period; Prognosis; Retrospective Studies; Statistical analysis; Surgery; Survival; Survival Rate; Switzerland - epidemiology; Tumor Burden; Tumor burden score; Tumors; Veins & arteries
• ISSN: 0960-7404; 1879-3320
• DOI: 10.1016/j.suronc.2021.101631

Modern chemotherapy and repeat hepatectomy allow to tailor the surgical strategies for the treatment of colorectal liver metastases (CRLM). This study addresses the hypothesis that parenchymal-sparing hepatectomy reduces postoperative complications while ensuring similar oncologic outcomes compared to the standardized non-parenchymal-sparing procedures. Clinicopathological data of patients who underwent liver resection for CRLM between 2012 and 2019 at a hepatobiliary center in Switzerland were assessed. Patients were stratified according to the tumor burden score [TBS2 = (maximum tumor diameter in cm)2 + (number of lesions)2)] and were dichotomized in a lower and a higher tumor burden cohort according to the median TBS. Postoperative outcomes, overall survival (OS) and recurrence-free survival (RFS) of patients following parenchymal-sparing resection (PSR) for CRLM were compared with those of patients undergoing non-PSR. During the study period, 153 patients underwent liver resection for CRLM with curative intent. PSR was performed in 79 patients with TBS