TY - JOUR
T1 - Trends and overall survival after combined liver resection and thermal ablation of colorectal liver metastases
T2 - a nationwide population-based propensity score-matched study
AU - Dutch Hepato Biliary Audit Group, Collaborators
AU - de Graaff, Michelle R
AU - Klaase, Joost M
AU - den Dulk, Marcel
AU - Coolsen, Marielle M E
AU - Kuhlmann, Koert F D
AU - Verhoef, Cees
AU - Hartgrink, Henk H
AU - Derksen, Wouter J M
AU - van den Boezem, Peter
AU - Rijken, Arjen M
AU - Gobardhan, Paul
AU - Liem, Mike S L
AU - Leclercq, Wouter K G
AU - Marsman, Hendrik A
AU - van Duijvendijk, Peter
AU - Bosscha, Koop
AU - Elfrink, Arthur K E
AU - Manusama, Eric R
AU - Belt, Eric J Th
AU - Doornebosch, Pascal G
AU - Oosterling, Steven J
AU - Ruiter, Simeon J S
AU - Grünhagen, Dirk J
AU - Burgmans, Mark
AU - Meijerink, Martijn
AU - Kok, Niels F M
AU - Swijnenburg, Rutger-Jan
N1 - Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.
PY - 2024/1
Y1 - 2024/1
N2 - BACKGROUND: In colorectal liver metastases (CRLM) patients, combination of liver resection and ablation permit a more parenchymal-sparing approach. This study assessed trends in use of combined resection and ablation, outcomes, and overall survival (OS).METHODS: This population-based study included all CRLM patients who underwent liver resection between 2014 and 2022. To assess OS, data was linked to two databases containing date of death for patients treated between 2014 and 2018. Hospital variation in the use of combined minor liver resection and ablation versus major liver resection alone in patients with 2-3 CRLM and ≤3 cm was assessed. Propensity score matching (PSM) was applied to evaluate outcomes.RESULTS: This study included 3593 patients, of whom 1336 (37.2%) underwent combined resection and ablation. Combined resection increased from 31.7% in 2014 to 47.9% in 2022. Significant hospital variation (range 5.9-53.8%) was observed in the use of combined minor liver resection and ablation. PSM resulted in 1005 patients in each group. Major morbidity was not different (11.6% vs. 5%, P = 1.00). Liver failure occurred less often after combined resection and ablation (1.9% vs. 0.6%, P = 0.017). Five-year OS rates were not different (39.3% vs. 33.9%, P = 0.145).CONCLUSION: Combined resection and ablation should be available and considered as an alternative to resection alone in any patient with multiple metastases.
AB - BACKGROUND: In colorectal liver metastases (CRLM) patients, combination of liver resection and ablation permit a more parenchymal-sparing approach. This study assessed trends in use of combined resection and ablation, outcomes, and overall survival (OS).METHODS: This population-based study included all CRLM patients who underwent liver resection between 2014 and 2022. To assess OS, data was linked to two databases containing date of death for patients treated between 2014 and 2018. Hospital variation in the use of combined minor liver resection and ablation versus major liver resection alone in patients with 2-3 CRLM and ≤3 cm was assessed. Propensity score matching (PSM) was applied to evaluate outcomes.RESULTS: This study included 3593 patients, of whom 1336 (37.2%) underwent combined resection and ablation. Combined resection increased from 31.7% in 2014 to 47.9% in 2022. Significant hospital variation (range 5.9-53.8%) was observed in the use of combined minor liver resection and ablation. PSM resulted in 1005 patients in each group. Major morbidity was not different (11.6% vs. 5%, P = 1.00). Liver failure occurred less often after combined resection and ablation (1.9% vs. 0.6%, P = 0.017). Five-year OS rates were not different (39.3% vs. 33.9%, P = 0.145).CONCLUSION: Combined resection and ablation should be available and considered as an alternative to resection alone in any patient with multiple metastases.
U2 - 10.1016/j.hpb.2023.09.012
DO - 10.1016/j.hpb.2023.09.012
M3 - Article
C2 - 37777384
SN - 1365-182X
VL - 26
SP - 34
EP - 43
JO - HPB
JF - HPB
IS - 1
ER -