TY - JOUR
T1 - Impact of neoadjuvant chemotherapy on the difficulty and outcomes of laparoscopic and robotic major liver resections for colorectal liver metastases
T2 - A propensity-score and coarsened exact-matched controlled study
AU - International robotic and laparoscopic liver resection study group investigators
AU - Ghotbi, Jacob
AU - Aghayan, Davit
AU - Fretland, Åsmund
AU - Edwin, Bjørn
AU - Syn, Nicholas L.
AU - Cipriani, Federica
AU - Alzoubi, Mohammed
AU - Lim, Chetana
AU - Scatton, Olivier
AU - Long, Tran Cong duy
AU - Herman, Paulo
AU - Coelho, Fabricio Ferreira
AU - Marino, Marco V.
AU - Mazzaferro, Vincenzo
AU - Chiow, Adrian K.H.
AU - Sucandy, Iswanto
AU - Ivanecz, Arpad
AU - Choi, Sung Hoon
AU - Lee, Jae Hoon
AU - Prieto, Mikel
AU - Vivarelli, Marco
AU - Giuliante, Felice
AU - Ruzzenente, Andrea
AU - Yong, Chee Chien
AU - Yin, Mengqiu
AU - Fondevila, Constantino
AU - Efanov, Mikhail
AU - Morise, Zenichi
AU - Di Benedetto, Fabrizio
AU - Brustia, Raffaele
AU - Dalla Valle, Raffaele
AU - Boggi, Ugo
AU - Geller, David
AU - Belli, Andrea
AU - Memeo, Riccardo
AU - Mejia, Alejandro
AU - Park, James O.
AU - Rotellar, Fernando
AU - Choi, Gi Hong
AU - Robles-Campos, Ricardo
AU - Wang, Xiaoying
AU - Sutcliffe, Robert P.
AU - Pratschke, Johann
AU - Tang, Chung Ngai
AU - Chong, Charing C.N.
AU - D'Hondt, Mathieu
AU - Monden, Kazuteru
AU - Sugioka, Atsushi
AU - Kato, Yutaro
AU - Kojima, Masayuki
N1 - Publisher Copyright:
© 2023 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology
PY - 2023/7
Y1 - 2023/7
N2 - Background: Minimal invasive liver resections are a safe alternative to open surgery. Different scoring systems considering different risks factors have been developed to predict the risks associated with these procedures, especially challenging major liver resections (MLR). However, the impact of neoadjuvant chemotherapy (NAT) on the difficulty of minimally invasive MLRs remains poorly investigated. Methods: Patients who underwent laparoscopic and robotic MLRs for colorectal liver metastases (CRLM) performed across 57 centers between January 2005 to December 2021 were included in this analysis. Patients who did or did not receive NAT were matched based on 1:1 coarsened exact and 1:2 propensity-score matching. Pre- and post-matching comparisons were performed. Results: In total, the data of 5189 patients were reviewed. Of these, 1411 procedures were performed for CRLM, and 1061 cases met the inclusion criteria. After excluding 27 cases with missing data on NAT, 1034 patients (NAT: n = 641; non-NAT: n = 393) were included. Before matching, baseline characteristics were vastly different. Before matching, the morbidity rate was significantly higher in the NAT-group (33.2% vs. 27.2%, p-value = 0.043). No significant differences were seen in perioperative outcomes after the coarsened exact matching. After the propensity-score matching, statistically significant higher blood loss (mean, 300 (SD 128–596) vs. 250 (SD 100–400) ml, p-value = 0.047) but shorter hospital stay (mean, 6 [4-8] vs. 6 [5-9] days, p-value = 0.043) were found in the NAT-group. Conclusion: The current study demonstrated that NAT had minimal impact on the difficulty and outcomes of minimally-invasive MLR for CRLM.
AB - Background: Minimal invasive liver resections are a safe alternative to open surgery. Different scoring systems considering different risks factors have been developed to predict the risks associated with these procedures, especially challenging major liver resections (MLR). However, the impact of neoadjuvant chemotherapy (NAT) on the difficulty of minimally invasive MLRs remains poorly investigated. Methods: Patients who underwent laparoscopic and robotic MLRs for colorectal liver metastases (CRLM) performed across 57 centers between January 2005 to December 2021 were included in this analysis. Patients who did or did not receive NAT were matched based on 1:1 coarsened exact and 1:2 propensity-score matching. Pre- and post-matching comparisons were performed. Results: In total, the data of 5189 patients were reviewed. Of these, 1411 procedures were performed for CRLM, and 1061 cases met the inclusion criteria. After excluding 27 cases with missing data on NAT, 1034 patients (NAT: n = 641; non-NAT: n = 393) were included. Before matching, baseline characteristics were vastly different. Before matching, the morbidity rate was significantly higher in the NAT-group (33.2% vs. 27.2%, p-value = 0.043). No significant differences were seen in perioperative outcomes after the coarsened exact matching. After the propensity-score matching, statistically significant higher blood loss (mean, 300 (SD 128–596) vs. 250 (SD 100–400) ml, p-value = 0.047) but shorter hospital stay (mean, 6 [4-8] vs. 6 [5-9] days, p-value = 0.043) were found in the NAT-group. Conclusion: The current study demonstrated that NAT had minimal impact on the difficulty and outcomes of minimally-invasive MLR for CRLM.
KW - Difficulty
KW - Laparoscopic liver resections
KW - Major resections
KW - Neoadjuvant chemotherapy
KW - Robotic liver resections
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UR - http://www.scopus.com/inward/citedby.url?scp=85149804350&partnerID=8YFLogxK
U2 - 10.1016/j.ejso.2023.01.014
DO - 10.1016/j.ejso.2023.01.014
M3 - Article
C2 - 36774216
AN - SCOPUS:85149804350
SN - 0748-7983
VL - 49
SP - 1209
EP - 1216
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 7
ER -