Parenchymal-sparing hepatectomies (PSH) for bilobar colorectal liver metastases are associated with a lower morbidity and similar oncological results: a propensity score matching analysis
Articolo
Data di Pubblicazione:
2016
Abstract:
Objective The aim of this study is to evaluate whether a parenchymal-sparing strategy provides similar results in terms of morbidity, mortality, and oncological outcome of non-PSH hepatectomies in a propensity score matched population (PSMP) in case of multiple (>3) bilobar colorectal liver metastases (CLM). Background The surgical treatment of bilobar liver metastasis is challenging due to the necessity to achieve complete resection margins and a sufficient future remnant liver. Two approaches are adaptable as follows: parenchymal-sparing hepatectomies (PSH) and extended hepatectomies (NON-PSH). Methods A total of 3036 hepatectomies were analyzed from a multicentric retrospective cohort of hepatectomies. Patients were matched in a 1:1 propensity score analysis in order to compare PSH versus NON-PSH resections. Results PSH was associated with a lower number of complications (≥1) (25% vs. 34%, p = 0.04) and a lower grade of Dindo-Clavien III and IV (10 vs. 16%, p = 0.03). Liver failure was less present in PSH (2 vs. 7%, p = 0.006), with a shorter ICU stay (0 day vs. 1 day, p = 0.004). No differences were demonstrated in overall and disease-free survival. Conclusion In conclusion, PSH resection for bilobar multiple CLMs represents a valid alternative to NON-PSH resection in selected patients with a reduced morbidity and comparable oncological results.
Tipologia CRIS:
1.1 Articolo in rivista
Elenco autori:
Memeo, R.; De Blasi, V.; Adam, R.; Goere, D.; Azoulay, D.; Ayav, A.; Gregoire, E.; Kianmanesh, R.; Navarro, F.; Sa Cunha, A.; Pessaux, P.; Cosse, C.; Lignier, D.; Regimbeau, J. M.; Barbieux, J.; Lermite, E.; Hamy, A.; Mauvais, F.; Laurent, C.; Naasan, I. A.; Laurent, A.; Compagnon, P.; Sbai Idrissi, M.; Martin, F.; Atger, J.; Baulieux, J.; Darnis, B.; Mabrut, J. Y.; Kepenekian, V.; Perinel, J.; Adham, M.; Glehen, O.; Rivoire, M.; Hardwigsen, J.; Palen, A.; Le Treut, Y. P.; Delpero, J. R.; Turrini, O.; Herrero, A.; Panaro, F.; Bresler, L.; Rauch, P.; Guillemin, F.; Marchal, F.; Gugenheim, J.; Iannelli, A.; Benoist, S.; Brouquet, A.; Pocard, M.; Dico, R. L.; Fuks, D.; Scatton, O.; Soubrane, O.; Vaillant, J. -C.; Piardi, T.; Sommacale, D.; Kianmanesh, R.; Comy, M.; Bachellier, P.; Oussoultzoglou, E.; Addeo, P.; Ntourakis, D.; Mutter, D.; Marescaux, J.; Raoux, L.; Suc, B.; Muscari, F.; Elhomsy, G.; Gelli, M.; Castaing, D.; Cherqui, D.; Pittau, G.; Ciacio, O.; Vibert, E.; Elias, D.; Vittadello, F.
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