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- Publisher Website: 10.1007/s00268-020-05506-1
- Scopus: eid_2-s2.0-85086345670
- PMID: 32535643
- WOS: WOS:000539968500004
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Article: Anatomical versus nonanatomical resection for colorectal liver metastasis
Title | Anatomical versus nonanatomical resection for colorectal liver metastasis |
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Authors | |
Issue Date | 2020 |
Publisher | Springer for International Society of Surgery. The Journal's web site is located at http://www.springer.com/medicine/surgery/journal/268 |
Citation | World Journal of Surgery, 2020, v. 44 n. 8, p. 2743-2751 How to Cite? |
Abstract | Background:
Anatomical resection (AR) for colorectal liver metastasis (CLM) is disputable. We investigated the impact of AR on short-term outcomes and survival in CLM patients.
Methods:
Patients having hepatectomy with AR or nonanatomical resection (NAR) for CLM were reviewed. Comparison was made between AR and NAR groups. Group comparison was performed again after propensity score matching with ratio 1:1.
Results:
AR group (n = 234 vs n = 89 in NAR group) had higher carcinoembryonic antigen level (20 vs 7.8 ng/mL, p ≤ 0.001), more blood loss (0.65 vs 0.2 L, p < 0.001), more transfusions (19.2% vs 3.4%, p = 0.001), longer operation (339.5 vs 180 min, p < 0.001), longer hospital stay (9 vs 6 days, p < 0.001), more tumors (p < 0.001), larger tumors (4 vs 2 cm, p < 0.001), more bilobar involvement (20.9% vs 7.9%, p = 0.006), and comparable survival (overall, p = 0.721; disease-free, p = 0.695). After propensity score matching, each group had 70 patients, with matched tumor number, tumor size, liver function, and tumor marker. AR group had more open resections (85.7% vs 68.6%, p = 0.016), more blood loss (0.556 vs 0.3 L, p = 0.001), more transfusions (17.1% vs 4.3%, p = 0.015), longer operation (310 vs 180 min, p < 0.001), longer hospital stay (8.5 vs 6 days, p = 0.002), comparable overall survival (p = 0.819), and comparable disease-free survival (p = 0.855).
Conclusion:
Similar disease-free survival and overall survival of CLM patients were seen with the use of AR and NAR. However, AR may entail a more eventful postoperative course. NAR with margin should be considered whenever feasible. |
Persistent Identifier | http://hdl.handle.net/10722/285317 |
ISSN | 2023 Impact Factor: 2.3 2023 SCImago Journal Rankings: 0.772 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | She, WH | - |
dc.contributor.author | Cheung, TT | - |
dc.contributor.author | Ma, KW | - |
dc.contributor.author | Tsang, SHY | - |
dc.contributor.author | Dai, WC | - |
dc.contributor.author | Chan, ACY | - |
dc.contributor.author | Lo, CM | - |
dc.date.accessioned | 2020-08-18T03:52:21Z | - |
dc.date.available | 2020-08-18T03:52:21Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | World Journal of Surgery, 2020, v. 44 n. 8, p. 2743-2751 | - |
dc.identifier.issn | 0364-2313 | - |
dc.identifier.uri | http://hdl.handle.net/10722/285317 | - |
dc.description.abstract | Background: Anatomical resection (AR) for colorectal liver metastasis (CLM) is disputable. We investigated the impact of AR on short-term outcomes and survival in CLM patients. Methods: Patients having hepatectomy with AR or nonanatomical resection (NAR) for CLM were reviewed. Comparison was made between AR and NAR groups. Group comparison was performed again after propensity score matching with ratio 1:1. Results: AR group (n = 234 vs n = 89 in NAR group) had higher carcinoembryonic antigen level (20 vs 7.8 ng/mL, p ≤ 0.001), more blood loss (0.65 vs 0.2 L, p < 0.001), more transfusions (19.2% vs 3.4%, p = 0.001), longer operation (339.5 vs 180 min, p < 0.001), longer hospital stay (9 vs 6 days, p < 0.001), more tumors (p < 0.001), larger tumors (4 vs 2 cm, p < 0.001), more bilobar involvement (20.9% vs 7.9%, p = 0.006), and comparable survival (overall, p = 0.721; disease-free, p = 0.695). After propensity score matching, each group had 70 patients, with matched tumor number, tumor size, liver function, and tumor marker. AR group had more open resections (85.7% vs 68.6%, p = 0.016), more blood loss (0.556 vs 0.3 L, p = 0.001), more transfusions (17.1% vs 4.3%, p = 0.015), longer operation (310 vs 180 min, p < 0.001), longer hospital stay (8.5 vs 6 days, p = 0.002), comparable overall survival (p = 0.819), and comparable disease-free survival (p = 0.855). Conclusion: Similar disease-free survival and overall survival of CLM patients were seen with the use of AR and NAR. However, AR may entail a more eventful postoperative course. NAR with margin should be considered whenever feasible. | - |
dc.language | eng | - |
dc.publisher | Springer for International Society of Surgery. The Journal's web site is located at http://www.springer.com/medicine/surgery/journal/268 | - |
dc.relation.ispartof | World Journal of Surgery | - |
dc.title | Anatomical versus nonanatomical resection for colorectal liver metastasis | - |
dc.type | Article | - |
dc.identifier.email | She, WH: brianshe@hku.hk | - |
dc.identifier.email | Cheung, TT: cheung68@hku.hk | - |
dc.identifier.email | Dai, WC: daiwc@hku.hk | - |
dc.identifier.email | Chan, ACY: acchan@hku.hk | - |
dc.identifier.email | Lo, CM: chungmlo@hkucc.hku.hk | - |
dc.identifier.authority | Cheung, TT=rp02129 | - |
dc.identifier.authority | Chan, ACY=rp00310 | - |
dc.identifier.authority | Lo, CM=rp00412 | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1007/s00268-020-05506-1 | - |
dc.identifier.pmid | 32535643 | - |
dc.identifier.scopus | eid_2-s2.0-85086345670 | - |
dc.identifier.hkuros | 312943 | - |
dc.identifier.volume | 44 | - |
dc.identifier.issue | 8 | - |
dc.identifier.spage | 2743 | - |
dc.identifier.epage | 2751 | - |
dc.identifier.isi | WOS:000539968500004 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 0364-2313 | - |