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Laparoscopic Versus Open Thermal Ablation of Colorectal Liver Metastases: A Propensity Score-Based Analysis of Local Control of the Ablated Tumors

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Laparoscopic ablation (LA) of colorectal liver metastases (CRLMs) is frequently performed in combination with laparoscopic liver resection or as a stand-alone procedure. However, LA is technically demanding and whether the results are comparable with those of open ablation (OA) has not been determined to date. This study compared the effectiveness of LA and OA in achieving local tumor control of CRLMs.

Methods

Patients undergoing LA or OA of CRLMs at Ghent University Hospital between June 2007 and February 2018 were identified from a prospective database. Lesions treated by LA and OA were matched 1:1 using a propensity score based on lesions (liver segment, size, deepness, proximity to a vessel), patients, and procedural characteristics. Ablation sites were followed up with computed-tomography or magnetic resonance imaging to assess the completeness of the ablation and ablation-site recurrence (ASR). Analysis of ASR was performed with the Kaplan–Meier method and Cox regression.

Results

In this study, 163 patients underwent the surgical ablation (78 LA, 85 OA) of 333 CRLMs (143 LA, 190 OA). After matching, 220 lesions (110 LA, 110 OA) were analyzed. Ablation was complete in 93.7% (LA) and 97.3% (OA) of the sites (p = 0.195). No difference in ASR was observed (p = 0.351), with a cumulative risk of ASR at 12 months of 9.1% (LA) and 8.2% (OA). After multivariable analysis, ASR was confirmed to be independent of the surgical approach.

Conclusion

The findings showed that LA and OA achieve a comparable local control of CRLMs. This result further supports the adoption of a laparoscopic approach for the treatment of CRLMs.

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Authors and Affiliations

  1. Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy

    Mariano Cesare Giglio MD & Roberto Ivan Troisi MD, MSc, PhD

  2. Department of Human Structure and Repair, Faculty of Medicine, Ghent University, Ghent, Belgium

    Bram Logghe MBBS, Federico Tomassini MD, Aude Vanlander MD, Giammauro Berardi MD & Roberto Ivan Troisi MD, MSc, PhD

  3. Student in Erasmus Exchange Programme, Faculty of Medicine, Sapienza University of Rome, Rome, Italy

    Eleonora Garofalo MD

  4. Department of Public Health, Federico II University, Naples, Italy

    Roberto Montalti MD, PhD

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Giglio, M.C., Logghe, B., Garofalo, E. et al. Laparoscopic Versus Open Thermal Ablation of Colorectal Liver Metastases: A Propensity Score-Based Analysis of Local Control of the Ablated Tumors. Ann Surg Oncol 27, 2370–2380 (2020). https://doi.org/10.1245/s10434-020-08243-w

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