Bilobar versus unilobar multiple colorectal liver metastases: a propensity score analysis of surgical outcomes and recurrence patterns

• Published in: Journal of hepato-biliary-pancreatic sciences Vol. 24; no. 3; pp. 153 - 160
• Main Authors: Fukami, Yasuyuki, Kaneoka, Yuji, Maeda, Atsuyuki, Takayama, Yuichi, Takahashi, Takamasa, Onoe, Shunsuke, Uji, Masahito, Wakai, Kenji
• Format: Journal Article
• Language: English
• Published: Japan Wiley Subscription Services, Inc 01.03.2017
• Subjects: Aged; Bilobar; Colorectal liver metastases; Colorectal Neoplasms - pathology; Female; Hepatectomy; Hepatectomy - methods; Humans; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Male; Medical prognosis; Metastasis; Middle Aged; Neoplasm Recurrence, Local; Prognosis; Propensity Score; Recurrence; Risk Factors; Survival Rate; Recurrence; Propensity score; Colorectal liver metastases; Bilobar; Hepatectomy
• ISSN: 1868-6974; 1868-6982
• DOI: 10.1002/jhbp.427

Background Bilobar multiple colorectal liver metastases (MCLM) are often considered incurable or associated with a poor prognosis even after R0 resection. This study was designed to compare the long‐term outcomes and recurrence patterns after one‐stage resection in patients with bilobar versus unilobar MCLM. Methods The records of patients undergoing parenchymal‐sparing intent hepatectomy between 1994 and 2015 were reviewed. Survival and recurrence patterns were analyzed by propensity score matching. Results The study population included 140 patients: 81 patients with bilobar MCLM versus 59 patients with unilobar MCLM. In the propensity score matching analysis (bilobar, n = 35 vs. unilobar, n = 35), the short‐term outcomes did not differ between the two groups. Five‐year overall survival (54.8% in bilobar vs. 51.2% in unilobar; P = 0.388) and recurrence‐free survival (28.5% in bilobar vs. 36.2% in unilobar; P = 0.261) also did not differ. No significant differences were found in liver‐only recurrence (22.9% in bilobar vs. 25.7% in unilobar; P = 1.000) and other recurrence patterns. Conclusions The clearance of bilobar MCLM by one‐stage resection of parenchymal‐sparing intent provided comparable long‐term survival to unilobar MCLM. HighlightFukami and colleagues retrospectively assessed the long‐term outcomes and recurrence patterns after one‐stage resection in patients with bilobar versus unilobar multiple colorectal liver metastases using propensity score matching analysis. No significant differences in overall survival and recurrence patterns after resection were found between bilobar and unilobar multiple colorectal liver metastases.