A systematic review and meta-analysis comparing the short- and long-term outcomes for laparoscopic and open liver resections for liver metastases from colorectal cancer

Ciria, Rubén; Ocaña, Sira; Gómez‐Luque, Irene; Cipriani, Federica; Halls, Mark; Fretland, Åsmund Avdem; Okuda, Yasuhiro; Aroori, Somaiah; Briceño, Javier; Aldrighetti, Luca; Edwin, Bjørn; Hilal, Mohammed Abu

doi:10.1007/s00464-019-06774-2

Cited by 60 publications

(36 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Laparoscopic liver resection is nowadays adopted worldwide for the treatment of liver tumors including CRLM. Numerous studies have reported the benefits of laparoscopic liver resection compared with the standard open liver resection, such as reduced intraoperative bleeding, a lower morbidity rate, cost‐effectiveness, and shorter in‐hospital stay . In addition, laparoscopic liver resection has been reported to provide comparable long‐term oncological outcomes with open liver resection .…”

Section: Other Possible Methods For Improving Patients’ Outcomesmentioning

confidence: 99%

“…Numerous studies have reported the benefits of laparoscopic liver resection compared with the standard open liver resection, such as reduced intraoperative bleeding, a lower morbidity rate, cost‐effectiveness, and shorter in‐hospital stay . In addition, laparoscopic liver resection has been reported to provide comparable long‐term oncological outcomes with open liver resection . Another possible benefit is that less invasiveness of laparoscopic liver resection may lead to rapid initiation of postoperative chemotherapy .…”

Section: Other Possible Methods For Improving Patients’ Outcomesmentioning

confidence: 99%

See 1 more Smart Citation

How to increase the resectability of initially unresectable colorectal liver metastases: A surgical perspective

Imai

Adam

Baba

2019

Annals of Gastroent Surgery

View full text Add to dashboard Cite

Although surgical resection is the only treatment of choice that can offer prolonged survival and a chance of cure in patients with colorectal liver metastases (CRLM), nearly 80% of patients are deemed to be unresectable at the time of diagnosis. Considerable efforts have been made to overcome this initial unresectability, including expanding the indication of surgery, the advent of conversion chemotherapy, and development and modification of specific surgical techniques, regulated under multidisciplinary approaches. In terms of specific surgical techniques, portal vein ligation/embolization can increase the volume of future liver remnant and thereby reduce the risk of hepatic insufficiency and death after major hepatectomy. For multiple bilobar CRLM that were traditionally considered unresectable even with preoperative chemotherapy and portal vein embolization, two‐stage hepatectomy was introduced and has been adopted worldwide with acceptable short‐ and long‐term outcomes. Recently, ALPPS (associating liver partition and portal vein ligation for staged hepatectomy) was reported as a novel variant of two‐stage hepatectomy. Although issues regarding safety remain unresolved, rapid future liver remnant hypertrophy and subsequent shorter intervals between the two stages lead to a higher feasibility rate, reaching 98%. In addition, adding radiofrequency ablation and vascular resection and reconstruction techniques can allow expansion of the pool of patients with CRLM who are candidates for liver resection and thus a cure. In this review, we discuss specific techniques that may expand the criteria for resectability in patients with initially unresectable CRLM.

show abstract

Section: Other Possible Methods For Improving Patients’ Outcomesmentioning

confidence: 99%

Section: Other Possible Methods For Improving Patients’ Outcomesmentioning

confidence: 99%

How to increase the resectability of initially unresectable colorectal liver metastases: A surgical perspective

Imai

Adam

Baba

2019

Annals of Gastroent Surgery

View full text Add to dashboard Cite

show abstract

“…18 A meta-analysis study also showed equivalent rates of negative resection margins and there were no differences in overall or diseasefree survival. 19 So, LLS for CRLM may offer better short-term outcomes than open liver resection with comparative longterm outcomes. However, a subgroup analysis from the OSLO-SOMET randomized controlled trial showed LLS in the posterosuperior segments, which is technically challenging, had comparative postoperative complication rate when compared with open liver resection, and the blood loss was less in open liver resection group.…”

Section: Surgical Refinementmentioning

confidence: 99%

Evolution of Surgical Management of Colorectal Liver Metastasis

2020

View full text Add to dashboard Cite

The treatment of colorectal liver metastasis (CRLM) has progressed markedly in the past decades. Main contributions stem from improvement in surgical approach and applications of chemotherapy. The availability of several perioperative and surgical techniques, including portal vein embolization, ablation techniques, and two-stage hepatectomies, has expanded surgical indications. In addition, preoperative imaging methods have contributed to these advances.In patients with high oncological risk of recurrence, or initially unresectable CRLM, highly individualized treatment regimens are becoming more widely utilized. These patients should be evaluated for surgical resection after several cycles of chemotherapy given the survival benefit afforded by liver resection for CRLM. Several biomarkers, including RAS mutation, BRAF mutation, and microsatellite stability, have become essential in guiding therapy. Immunotherapy has recently been highlighted, especially for cases of microsatellite instability. Looking forward, biomarkers will likely to continue to guide individualized treatment patterns.Liver transplantation as an option for patients with unresectable CRLM may boast comparable outcomes to patients with primary liver tumors, but it remains controversial considering the limited supply of donor livers.Management of CRLM requires the complex decision making process common to contemporary tumor board discussions, and a multidisciplinary approach likely figures into future directions of management for CRLM.

show abstract

“…Benefits of minimally invasive liver surgery (MILS) have been documented, with a high level of evidence provided by randomized controlled trials, meta‐analyses and systematic reviews, in terms of reduced blood loss, morbidity, and faster functional recovery after surgery in the setting of liver malignancies, including colorectal metastases, hepatocellular carcinoma and intrahepatic cholangiocarcinoma . Consequently, MILS has presently entered clinical practice, with an increasing proportion of candidates to minimally invasive techniques, related to the strong commitment of surgeon towards this approach and the awareness of patients regarding its benefits …”

Section: Introductionmentioning

confidence: 99%

Appraisal of disease‐specific benefits of minimally invasiveness in surgery of breast cancer liver metastases

Ratti

Serenari

Zanello³

et al. 2019

Journal of Surgical Oncology

Self Cite

View full text Add to dashboard Cite

Background:The primary endpoint of this study is to analyze short term benefit of laparoscopic approach (minimally invasive liver surgery [MILS]) over the open techniques in patients submitted to surgery for breast cancer liver metastases (BCLM) within a disease-specific perspective. Material and Methods: A group of 30 patients who underwent laparoscopic liver resection for BCLM constituted the Study group (MILS group) and was matched in a ratio of 1:2 with patients who underwent open surgery for BCLM (Open group, constituting the Control group).Results: MILS approach resulted in a statistically significant lower blood loss (150 vs 300 mL; P < .05). The rate of postoperative complications was similar (13.3% and 16.6% in the MILS and Open groups, respectively). MILS approach was associated with a shorter length of postoperative stay (4 ± 2 days) compared with the Open group (7 ± 3 days), allowing a faster return to adjuvant treatments. Both MILS and open groups showed adequate oncological radicality, with comparable long-term results.Conclusion: MILS approach to BCLM represents the optimal instrument to obtain an adequate disease clearance in the selected group of patients candidates to surgery: the type of procedure (minor resections for limited hepatic disease) and characteristics of patients contribute to enhance the feasibility and the benefits of the laparoscopic technique. K E Y W O R D Sbreast cancer, laparoscopy, liver metastases, liver resection, outcome | INTRODUCTIONBenefits of minimally invasive liver surgery (MILS) have been documented, with a high level of evidence provided by randomized controlled trials, meta-analyses and systematic reviews, in terms of reduced blood loss, morbidity, and faster functional recovery after surgery 1-4 in the setting of liver malignancies, including colorectal metastases, 4-6 hepatocellular carcinoma 7,8 and intrahepatic cholangiocarcinoma. 9 Consequently, MILS has presently entered clinical practice, with an increasing proportion of candidates to minimally invasive techniques, related to the strong commitment of surgeon towards this approach and the awareness of patients regarding its benefits. 1,2,10,11 While many advantages of laparoscopy are transversally detectable 1,2 -irrespectively of the indication to liver resection-others Francesca Ratti and Matteo Serenari share the first authorship.

show abstract

A systematic review and meta-analysis comparing the short- and long-term outcomes for laparoscopic and open liver resections for liver metastases from colorectal cancer

Cited by 60 publications

References 57 publications

How to increase the resectability of initially unresectable colorectal liver metastases: A surgical perspective

How to increase the resectability of initially unresectable colorectal liver metastases: A surgical perspective

Evolution of Surgical Management of Colorectal Liver Metastasis

Appraisal of disease‐specific benefits of minimally invasiveness in surgery of breast cancer liver metastases

Contact Info

Product

Resources

About