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Surgical Endoscopy

, Volume 32, Issue 12, pp 4788–4797 | Cite as

Recurrence patterns after laparoscopic resection of colorectal liver metastases

  • Nicolas Tabchouri
  • Brice Gayet
  • Shinya Okumura
  • Gianfranco Donatelli
  • Marc Beaussier
  • Mostefa Bennamoun
  • Christophe Louvet
  • David FuksEmail author
Article

Abstract

Background

The major issue after liver resection for colorectal liver metastases (CRLM) is the high incidence of recurrence. Unlike open liver resection (OLR), recurrence following laparoscopic liver resection (LLR) is not well documented. The aim of this study was to analyze recurrence patterns and treatment following LLR for CRLM.

Study design

All patients who underwent LLR for CRLM from 2000 to 2016 were reviewed. Patients who presented with recurrence were compared to those who did not. Recurrence-free survival (RFS), overall survival (OS), and risk of recurrence and survival prognostic factors were analyzed.

Results

Overall, 273 patients were included, of which 157 (57.5%) were treated for one liver metastasis (LM). Median follow-up was 41 (12–187) months and associated extrahepatic disease was present in 27% of patients (mainly pulmonary, 65%). After a median of 16 (3–151) months, 197 (72%) patients presented with recurrence. Recurrences were early (< 6 months) in 22.8% of cases, occured in a single site in 66% and were intrahepatic, extrahepatic, or both in 44, 30, and 26%, respectively. Recurrences were treated with surgery or chemotherapy only in 45 and 47%, respectively. 3-, 5-, and 10-year OS was 82, 71, and 43%, respectively. Independent risk factors for recurrence were node-positive primary tumor, extrahepatic disease before hepatectomy, and R1 resection.

Conclusion

LLR for CRLM does not seem to be associated with distinctive recurrence patterns. LLR for CRLM yielded satisfying RFS and OS and should therefore be considered whenever possible.

Keywords

Colorectal liver metastases Laparoscopic liver resection Recurrence Management 

Abbreviations

CRLM

Colorectal liver metastases

OS

Overall survival

RFA

Radiofrequency ablation

LLR

Laparoscopic liver resection

OLR

Open liver resection

CCI

Comprehensive complication index

RFS

Recurrence-free survival

EHD

Extrahepatic disease

CT-scan

Computerized tomography scanner

MRI

Magnetic resonance imaging

Notes

Compliance with ethical standards

Disclosures

The authors Nicolas Tabchouri, Brice Gayet, Shinya Okumura, Gianfranco Donatelli, Marc Beaussier, Mostefa Bennamoun, Christophe Louvet, and David Fuks have nothing to declare.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Nicolas Tabchouri
    • 1
    • 2
  • Brice Gayet
    • 1
  • Shinya Okumura
    • 1
  • Gianfranco Donatelli
    • 1
  • Marc Beaussier
    • 1
  • Mostefa Bennamoun
    • 3
  • Christophe Louvet
    • 3
  • David Fuks
    • 1
    Email author
  1. 1.Department of Digestive Disease, Institut Mutualiste MontsourisUniversité Paris DescartesParisFrance
  2. 2.Department of Digestive SurgeryTrousseau HospitalChambray-lès-ToursFrance
  3. 3.Department of OncologyInstitut Mutualiste MontsourisParisFrance

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