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Outcomes of different parenchymal-sparing hepatectomies in patients with colorectal liver metastases and prognostic impact of peritumoral imaging features

  • Hepatobiliary
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Abstract

Objectives

Parenchymal-sparing hepatectomy (PSH) is recommended in patients with colorectal liver metastases (CRLM). Based on the principle of PSH, to investigate the impact of anatomical resection (AR) and non-anatomic resection (NAR) on the outcome of CRLM and to evaluate the potential prognostic impact of three peritumoral imaging features.

Methods

Fifty-six patients who had abdominal gadoxetic acid-enhanced magnetic resonance imaging (MRI) before CRLM surgery were included in this retrospective research. Peritumoral early enhancement, peritumoral hypointensity on hepatobiliary phase (HBP), and biliary dilatation to the CRLM at MRI were evaluated. Survival estimates were calculated using the Kaplan-Meier method, and multivariate analysis was conducted to identify independent predictors of liver recurrence-free survival (LRFS), recurrence-free survival (RFS) and overall survival (OS).

Results

NAR had a lower 3-year LRFS compared with AR (36.6% vs. 78.6%, p = 0.012). No significant differences were found in 3-year RFS (34.1% vs. 41.7%) and OS (61.7% vs. 81.3%) (p > 0.05). In NAR group, peritumoral early enhancement was associated with poor LRFS (p = < 0.001, hazard ratio [HR] = 6.260; 95% confidence interval [CI], 2.322,16.876]) and poor RFS (p = 0.035, HR =2.516; 95% CI, 1.069,5.919). No independent predictors of CRLM were identified in the AR group.

Conclusions

In patients with CRLM, peritumoral early enhancement was a predictor of LRFS and RFS after NAR according to the principle of PSH.

Graphical abstract

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

CRLM:

Colorectal liver metastasis

PSH:

Parenchymal-sparing hepatectomy

AR:

Anatomic resection

NAR:

Non-anatomic resection

HBP:

Hepatobiliary phase

MRI:

Magnetic resonance imaging

CT:

Computed tomography

MDT:

Multidisciplinary team

CEA:

Carcinoembryonic antigen

AFP:

Alpha-fetoprotein

IQR:

Interquartile range

TR:

Time of repetition

TE:

Time of echo

LAVA-XV:

Liver acquisition with volume acceleration-extended volume

LRFS:

Liver recurrence-free survival

RFS:

Recurrence-free survival

OS:

Overall survival

HR:

Hazard ratio

CI:

Confidence interval

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Acknowledgements

Not applicable

Funding

This study was supported by the National Natural Scientific Foundation of China [Grant No. 81901909] and Program for Youth Innovation in Future Medicine, Chongqing Medical University [Grant No. W0096/03020202Y2021284].

Author information

Author notes

  1. Liu Liu and Lianghua Xie have contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, China

    Liu Liu, Yin Zhou, Huali Tang, Xiaofang Zhao, Ping Yang & Yun Mao

  2. Department of Radiology, Affiliated Hospital of Guilin Medical University, No 15, Lequn Road, Guilin Guangxi, China

    Lianghua Xie

  3. Department of Pathology, College of Basic Medicine, Chongqing Medical University, No.1 Yixueyuan Road, Yuzhong District, Chongqing, China

    Qingshu Li

  4. Molecular Medicine Diagnostic and Testing Center, Chongqing Medical University, No.1 Yixueyuan Road, Yuzhong District, Chongqing, China

    Qingshu Li

  5. School of Public Health, Chongqing Medical University, No.1 Yixueyuan Road, Yuzhong District, Chongqing, China

    Xun Lei

  6. Department of Radiology, Chongqing Dongnan Hospital, No.98 Tongjiang Avenue, Chayuan New District, Nan’an District, Chongqing, China

    Jiamei Wu

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Contributions

LL: collected, analyzed and interpreted the patient data regarding to survival, performed the statistical analysis and wrote the manuscript. LHX: collected the patient data and analyzed the patient data regarding to survival, performed the statistical analysis and wrote the manuscript. YZ: analyzed and interpreted the patient data. QSL: analyzed and interpreted the patient data. XL: performed the statistical analysis. HLT: was a major contributor in editing the manuscript. JMW: was a major contributor in editing the manuscript. XFZ: collected the patient data. PY: analyzed the patient data regarding to survival. YM: designed the study, interpreted the data, and was a major contributor in writing the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yun Mao.

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Liu, L., Xie, L., Zhou, Y. et al. Outcomes of different parenchymal-sparing hepatectomies in patients with colorectal liver metastases and prognostic impact of peritumoral imaging features. Abdom Radiol 48, 3728–3745 (2023). https://doi.org/10.1007/s00261-023-04044-3

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