Donadon M, et al. - This study sought to determine the outcome of patients with multiple colorectal liver metastases (CLM) undergoing parenchymal-sparing hepatectomy (PSH) instead of major hepatectomy (MH). PSH, in comparison to MH, resulted in decreased postoperative morbidity, and a trend of survival benefit. Whenever technically feasible, PSH should be considered a suitable alternative to MH.

Methods

• Researchers reviewed databases at 2 institutions. They applied a propensity score-matched analysis.
• Among 554 patients, they matched 110 undergoing PSH and 110 undergoing MH.
• They were similar in baseline characteristics, comorbidity, and tumor features.
• For this study, primary outcomes were short- and long-term outcomes.
• They were similar regarding baseline characteristics, comorbidity, and tumor features.
• Short- and long-term outcomes were the primary outcomes assessed.

Results

• Significantly higher morbidity was observed in the MH group, while the groups were significantly different regarding mortality.
• Findings revealed no differences in free-margins width, but there appeared a trend of increased survival in the PSH group with a median advantage of 6 months over the MH group.
• The T status (hazard ratio [HR] 2.6; p = 0.001), the N status (HR 2.9; p = 0.001), the timing of CLM diagnosis (HR 2.1; p = 0.002), the tumor number (HR 2.0; p = 0.001), the tumor size (HR 2.2; p = 0.015), and the neo-adjuvant chemotherapy (HR 1.7; p = 0.023) were the prognostic factors that were statistically and independently significant for survival.