TY - JOUR
T1 - Liver resection is justified for patients with bilateral multiple colorectal liver metastases
T2 - A propensity-score-matched analysis
AU - Omichi, Kiyohiko
AU - Shindoh, Junichi
AU - Cloyd, Jordan M.
AU - Mizuno, Takashi
AU - Chun, Yun Shin
AU - Conrad, Claudius
AU - Aloia, Thomas A.
AU - Tzeng, Ching Wei D.
AU - Vauthey, Jean Nicolas
N1 - Funding Information:
The authors would like to recognize Ms. Ruth Haynes for administrative support in the preparation of this manuscript and thank Stephanie Deming, employees of the Department of Scientific Publications at MD Anderson Cancer Center, for copyediting the manuscript. This research was supported in part by the National Institutes of Health through MD Anderson Cancer Center 's Support Grant, CA01667 .
Publisher Copyright:
© 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology
PY - 2018/1
Y1 - 2018/1
N2 - Background Increasingly, patients with multiple colorectal liver metastases (CLM) are surgically treated. Some studies have shown that patients with bilobar and unilobar multiple CLM have similar outcomes, but other have shown that patients with bilobar CLM have worse outcomes after resection. We aimed to compare clinical outcomes of surgical treatment of bilobar and unilobar CLM using propensity score matching. Methods The single-institution study included patients who underwent hepatectomy for ≥3 histologically confirmed CLM during 1998–2014. Clinicopathologic characteristics and long-term outcomes were compared between patients with bilobar and unilobar CLM in a propensity-score-adjusted cohort. Results A total of 473 patients met the inclusion criteria, 271 (57%) with bilobar and 202 (43%) with unilobar CLM. In the propensity-score-matched population (bilobar, 170; unilobar, 170), no differences were observed according to the distribution of CLM except for a greater frequency of concomitant ablation, and R1 resection in the bilobar group. There was no difference between the bilobar and unilobar groups in 5-year overall survival rates (46% and 49%, respectively; P = 0.740) or 3-year recurrence-free survival rates (21% and 24%, respectively; P = 0.674). Conclusions Tumor distribution may not affect the curability of surgery for multiple CLM. Liver resection would be justified for selected patients with bilobar CLM.
AB - Background Increasingly, patients with multiple colorectal liver metastases (CLM) are surgically treated. Some studies have shown that patients with bilobar and unilobar multiple CLM have similar outcomes, but other have shown that patients with bilobar CLM have worse outcomes after resection. We aimed to compare clinical outcomes of surgical treatment of bilobar and unilobar CLM using propensity score matching. Methods The single-institution study included patients who underwent hepatectomy for ≥3 histologically confirmed CLM during 1998–2014. Clinicopathologic characteristics and long-term outcomes were compared between patients with bilobar and unilobar CLM in a propensity-score-adjusted cohort. Results A total of 473 patients met the inclusion criteria, 271 (57%) with bilobar and 202 (43%) with unilobar CLM. In the propensity-score-matched population (bilobar, 170; unilobar, 170), no differences were observed according to the distribution of CLM except for a greater frequency of concomitant ablation, and R1 resection in the bilobar group. There was no difference between the bilobar and unilobar groups in 5-year overall survival rates (46% and 49%, respectively; P = 0.740) or 3-year recurrence-free survival rates (21% and 24%, respectively; P = 0.674). Conclusions Tumor distribution may not affect the curability of surgery for multiple CLM. Liver resection would be justified for selected patients with bilobar CLM.
KW - Bilobar
KW - Colorectal liver metastases
KW - Liver resection
KW - Overall survival
KW - Recurrence-free survival
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U2 - 10.1016/j.ejso.2017.11.006
DO - 10.1016/j.ejso.2017.11.006
M3 - Article
C2 - 29208318
AN - SCOPUS:85036607468
SN - 0748-7983
VL - 44
SP - 122
EP - 129
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 1
ER -