<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Background</h3>
<p>Two-stage hepatectomy (TSH) has been proposed for patients with bilateral liver tumours who have a high risk of posthepatectomy liver failure after one-stage hepatectomy (OSH). This study aimed to determine the outcomes of TSH for extensive bilateral colorectal liver metastases.</p>
</sec>
<sec><h3>Patients and methods</h3>
<p>A retrospective review of a prospectively maintained database of liver resections for colorectal liver metastases was conducted. The TSH group was compared to the OSH group in terms of perioperative outcomes and survival. Case-control matching was performed.</p>
</sec>
<sec><h3>Results</h3>
<p>A total of 632 consecutive liver resections for colorectal liver metastases were performed between 2000 and 2020. The study group (TSH group) consisted of 15 patients who completed TSH. The control group included 151 patients who underwent OSH. The case-control matching-OSH group consisted of 14 patients. The major morbidity and 90-day mortality rates were 40% and 13.3% in the TSH group, 20.5% and 4.6% in the OSH group and 28.6% and 7.1% in the case-control matching-OSH group, respectively. The recurrence-free survival, median overall survival, and 3- and 5-year survival rates were 5 months, 21 months, 33% and 13% in the TSH group; 11 months, 35 months, 49% and 27% in the OSH group; and 8 months, 23 months, 36% and 21%, respectively, in the case-control matching-OSH group, respectively.</p>
</sec>
<sec><h3>Conclusions</h3>
<p>TSH used to be a favourable therapeutic choice in a select population of patients. Now, OSH should be preferred whenever feasible because it has lower morbidity and equivalent oncological outcomes to those of completed TSH.</p>
</sec>
</abstract>

Background
Two-stage hepatectomy (TSH) has been proposed for patients with bilateral liver tumours who have a high risk of posthepatectomy liver failure after one-stage hepatectomy (OSH). This study aimed to determine the outcomes of TSH for extensive bilateral colorectal liver metastases.

Patients and methods
A retrospective review of a prospectively maintained database of liver resections for colorectal liver metastases was conducted. The TSH group was compared to the OSH group in terms of perioperative outcomes and survival. Case-control matching was performed.

Results
A total of 632 consecutive liver resections for colorectal liver metastases were performed between 2000 and 2020. The study group (TSH group) consisted of 15 patients who completed TSH. The control group included 151 patients who underwent OSH. The case-control matching-OSH group consisted of 14 patients. The major morbidity and 90-day mortality rates were 40% and 13.3% in the TSH group, 20.5% and 4.6% in the OSH group and 28.6% and 7.1% in the case-control matching-OSH group, respectively. The recurrence-free survival, median overall survival, and 3- and 5-year survival rates were 5 months, 21 months, 33% and 13% in the TSH group; 11 months, 35 months, 49% and 27% in the OSH group; and 8 months, 23 months, 36% and 21%, respectively, in the case-control matching-OSH group, respectively.

Conclusions
TSH used to be a favourable therapeutic choice in a select population of patients. Now, OSH should be preferred whenever feasible because it has lower morbidity and equivalent oncological outcomes to those of completed TSH.

Two-stage hepatectomy in resection of colorectal liver metastases – a single-institution experience with case-control matching and review of the literature

Clinical Department of Abdominal and General Surgery

Department of Surgery, Faculty of Medicine

Radiology and Oncology

This work is licensed under the Creative Commons Attribution 4.0 International License.

Background
Two-stage hepatectomy (TSH) has been proposed for patients with bilateral liver tumours who have a high risk of posthepatectomy liver failure after...

Two-stage hepatectomy in resection of colorectal liver metastases – a single-institution experience with case-control matching and review of the literature

Article Category: Research Article

Published Online: Jun 21, 2023

Page range: 270 - 278

Received: Mar 18, 2023

Accepted: May 15, 2023

DOI: https://doi.org/10.2478/raon-2023-0026

Keywords
colorectal cancer, liver metastases, hepatectomy, future liver remnant, posthepatectomy liver failure, survival analysis

© 2023 Spela Turk et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Two-stage hepatectomy in resection of colorectal liver metastases – a single-institution experience with case-control matching and review of the literature

Article Category: Research Article

Published Online: Jun 21, 2023

Page range: 270 - 278

Received: Mar 18, 2023

Accepted: May 15, 2023

DOI: https://doi.org/10.2478/raon-2023-0026

Keywordscolorectal cancer, liver metastases, hepatectomy, future liver remnant, posthepatectomy liver failure, survival analysis

© 2023 Spela Turk et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Keywords
colorectal cancer, liver metastases, hepatectomy, future liver remnant, posthepatectomy liver failure, survival analysis