Comparison of the effects of laparoscopic versus open liver resection for colorectal cancer liver metastasis on the surgery-chemotherapy interval: a propensity score matching analysis
10.3760/cma.j.cn113884-20230420-00127
- VernacularTitle:结直肠癌肝转移患者腹腔镜与开腹肝切除手术对手术-首次化疗时间间隔的影响
- Author:
Rui ZHANG
1
;
Yan GENG
;
Jing LIN
;
Jinhong CHEN
Author Information
1. 复旦大学附属华山医院普外科，上海 200040
- Keywords:
Colorectal neoplasms;
Propensity score;
Liver metastases;
Laparoscopic surgery
- From:
Chinese Journal of Hepatobiliary Surgery
2023;29(7):505-509
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the effects of laparoscopic versus open liver resection for colorectal cancer liver metastasis on the interval between surgery and chemotherapy, the perioperative outcomes and the prognosis of patients.Methods:A total of 127 patients undergoing colorectal cancer liver metastasis resection in the Department of General Surgery, Huashan Hospital, Fudan University, from January 2014 to February 2023 were retrospectively analyzed, including 81 males and 46 females, aged (60.0±8.9) years. Based on surgical approaches, the patients were divided into the laparoscopic group ( n=33) and the open group ( n=94). After propensity score matching (PSM), 26 cases in the laparoscopic group were matched with 45 cases in the open group. The maximum tumor diameter, proportion of tumors involving both lobes, and proportion of solitary tumors, interval between surgery and first cycle of chemotherapy, postoperative complications, postoperative hospital stay and the prognosis of patients were compared between the two groups after matching. Survival curves and rates were analyzed by Kaplan-Meier and log-rank test. Results:After PSM, there were no significant differences in the baseline data of patients, including tumor maximum diameter, proportion of tumors involving both lobes, and proportion of solitary tumors between the two groups (all P>0.05), indicating comparability. After matching, the interval between surgery and first cycle of chemotherapy in the laparoscopic group (34.4±11.2) d was shorter than that in the open group (46.7±28.0) d, the laparoscopic group had a lower incidence of postoperative complications[0 vs 20.0%(9/45)] and a shorter postoperative hospital stay[6.0 (5.0, 6.2) d vs 8.0 (7.0, 11.5) d] compared to the open group (all P<0.05). There was no significant difference in the recurrence-free survival rate (χ 2=3.27, P=0.070) and the cumulative survival rate (χ 2=0.001, P=0.974) between the two groups. Conclusion:In patients with colorectal cancer liver metastasis, laparoscopic liver surgery showed a lower incidence of postoperative complications and a shorter postoperative hospital stay compared to open surgery. The interval between surgery and first cycle of chemotherapy is shorter after laparoscopic surgery. The long-term prognosis is comparable in the laparoscopic and open surgery.
