Laparoscopic hepatic resection for metastatic liver tumor of colorectal cancer: comparative analysis of short and long term results

Shuichi Iwahashi, Mitsuo Shimada, Tohru Utsunomiya, Satoru Imura, Yuji Morine, Tetsuya Ikemoto, Yusuke Arakawa, Hiroki Mori, Mami Kanamoto, Shinichiro Yamada, Hidenori Miyake

Department of Surgery, Tokushima University

Introduction: With progress of surgical technique and devices, laparoscopic hepatectomy (LH) became a realizable option for patients with liver tumors. However, the feasibility of LH for metastatic liver tumor of colorectal cancer should be guaranteed also oncologically. Therefore, we evaluate the short and long term outcome of LH compared with open hepatectomy (OH) for metastatic liver tumor patients of colorectal cancer by matched pair analysis.

Patients and Methods: <Patients> Twenty patients with metastatic liver tumor of colorectal cancer who underwent Lap-Hx were enrolled in this study. Age ranged from 47 to 92 with a median of 67.0, and male: female was 15:5. Tumors were located in the entire liver, and tumor size ranged from 1.5 cm to 4.5 cm (median 2.0 cm) in the diameter. Operative procedures consisted of left Hx in 2, left medial segmentectomy in 1, left lateral segmentectomy in 4, subegmentectomy in 2, and partial Hx in 11 <Methods> The patients were compared with 20 matched patients who underwent open Hx (Open-Hx), in which the following parameters were matched; tumor size, tumor location and operative procedure. Both short- and long-term outcomes in Lap-Hx were compared with those in Open-Hx.

Results: No difference was observed between the two groups, in age, gender, tumor size, and operative procedures. <Short-term outcome> Operative time (371 +/- 132 min.) in Lap-Hx was similar to that in Open-Hx (370 +/- 146 min.). Blood loss (184 +/- 170 ml) in Lap-Hx was smaller than that in Open-Hx (312 +/- 227 ml) (P<0.05), and hospital stay (15.0 days) in Lap-Hx tended to be shorter than that in Open-Hx (17.5 days) (P=0.08). No difference was observed in incidence and kinds of postoperative complications between the two groups. <Long-term outcome> Overall survival rate was 100% at 1-year, 82% at 3-year and 41% at 5-year in LH group and 89% at 1-year, 89% at 3-year and 76% at 5-year in OH group. Disease-free survival rate was 51% at 1-year, 11% at 3-year and 11% at 5-year in LH group and 63% at 1-year, 31% at 3-year and 23% at 5-year in OH group. There was no significant difference in overall and disease-free survival between the two groups.

Conclusion: LH is safe and feasible option for selected metastatic liver tumor patients of colorectal cancer. The short and long term outcome of LH is also considered to be acceptable.

Session: Podium Presentation

Program Number: S006

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