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Comparison of various surgical approaches for extensive bilateral colorectal liver metastases

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Abstract

Purpose

Tailored operative strategies have been proposed for patients with bilobar colorectal liver metastases (CLM). The aim of the study was to evaluate the long-term outcome, safety and efficacy, including cancer-specific survival, morbidity, and mortality, of three different surgical strategies for extensive bilateral CLM.

Methods

This is a retrospective study of a prospective database of 356 consecutive patients, who underwent hepatic resection due to CLM between January 2003 and January 2009. Fifty-nine patients underwent three different therapeutic approaches: 22 patients with portal vein embolization (PVE) + staged resections, 11 patients with staged resections solely, and 26 patients with an extensive liver resection and simultaneous or subsequent radiofrequency ablation (RFA).

Results

The three groups were comparable regarding their general patient characteristics. The overall morbidity and mortality rates were 27.1 and 1.7 %, respectively. There were no significant differences in morbidity, mortality, or survival between the three groups. The median survival of all patients was 48 months, with a recurrence-free survival of 30 months.

Conclusions

The clearance of bilobar CLM can be achieved by various strategies, all of them providing an acceptable mortality rate and survival for the patients. Therefore, patients with bilobar liver metastases should receive a procedure tailored for their individual extent of disease.

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Authors and Affiliations

  1. Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany

    Christoph Reissfelder, Nuh N. Rahbari, L. Urrutia Bejarano, Thomas Schmidt, Markus W. Büchler, Jürgen Weitz & Moritz Koch

  2. Department of Radiology, University of Heidelberg, Heidelberg, Germany

    Nikolas Kortes & Hans-Ulrich Kauczor

  3. Department of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany

    Nuh N. Rahbari, Jürgen Weitz & Moritz Koch

  4. Department for Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technical University Dresden, Fetscherstr. 74, 01307, Dresden, Germany

    Christoph Reissfelder

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Correspondence to Christoph Reissfelder.

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Reissfelder, C., Rahbari, N.N., Bejarano, L.U. et al. Comparison of various surgical approaches for extensive bilateral colorectal liver metastases. Langenbecks Arch Surg 399, 481–491 (2014). https://doi.org/10.1007/s00423-014-1177-7

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  • DOI: https://doi.org/10.1007/s00423-014-1177-7

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