Long-term oncological outcomes after laparoscopic parenchyma-sparing redo liver resections for patients with metastatic colorectal cancer: a European multi-center study
| Autor: | Francesca Ratti, Airazat M. Kazaryan, Leonid Barkhatov, Thomas Armstrong, Giulio Belli, Åsmund Avdem Fretland, Davit L. Aghayan, Roberto Troisi, Ibrahim Dagher, Luca Aldrighetti, Federica Cipriani, Vincenzo Scuderi, Bjørn Edwin, Mohammad Abu Hilal, Andrea Belli |
|---|---|
| Přispěvatelé: | Barkhatov, L., Aghayan, D. L., Scuderi, V., Cipriani, F., Fretland, A. A., Kazaryan, A. M., Ratti, F., Armstrong, T., Belli, A., Dagher, I., Belli, G., Aldrighetti, L., Hilal, M. A., Troisi, R. I., Edwin, B. |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Palliative treatment Colorectal cancer Liver resections Internal medicine Hepatectomy Humans Medicine Retrospective Studies Parenchyma-sparing liver resections Rectal Neoplasms business.industry Liver Neoplasms Significant difference Margins of Excision Hepatology medicine.disease Surgery Colorectal liver metastases Redo liver resections Treatment Outcome Multi center study Colonic Neoplasms Resection margin Laparoscopy Neoplasm Recurrence Local Colorectal Neoplasms business Laparoscopic liver surgery Abdominal surgery |
| Zdroj: | Surgical Endoscopy. 36:3374-3381 |
| ISSN: | 1432-2218 0930-2794 |
| Popis: | Background Laparoscopic redo resections for colorectal metastases are poorly investigated. This study aims to explore long-term results after second, third, and fourth resections. Material and methods Prospectively updated databases of primary and redo laparoscopic liver resections in six European HPB centers were analyzed. Procedure-related overall survival after first, second, third, and fourth resections were evaluated. Furthermore, patients without liver recurrence after first liver resection were compared to those with one redo, two or three redo, and patients with palliative treatment for liver recurrence after first laparoscopic liver surgery. Survival was calculated both from the date of the first liver resection and from the date of the actual liver resection. In total, 837 laparoscopic primary and redo liver resections performed in 762 patients were included (630 primary, 172 first redo, 29 second redo, and 6 third redo). Patients were bunched into four groups: Group 1—without hepatic recurrence after primary liver resection (n = 441); Group 2—with liver recurrence who underwent only one laparoscopic redo resection (n = 154); Group 3—with liver recurrence who underwent two laparoscopic redo resections (n = 29); Group 4—with liver recurrence who have not been found suitable for redo resections (n = 138). Results No significant difference has been found between the groups in terms of baseline characteristics and surgical outcomes. Rate of positive resection margin was higher in the group with palliative recurrence (group 4). Five-year survival calculated from the first liver resection was 67%, 62%, 84%, and 7% for group 1, 2, 3, and 4, respectively. Procedure-specific 5-year overall survival was 50% after primary laparoscopic liver resection, 52% after the 1st reoperation, 52% after the 2nd, and 40% after the 3rd reoperation made laparoscopic. Conclusions Multiple redo recurrences can be performed laparoscopically with good long-term results. Liver recurrence does not aggravate prognosis as long as the patient is suitable for reoperation. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink