Abstract
Background
The definition of parenchymal sparing surgery (PSS) for colorectal liver metastases
(CRLM) diverges requiring a clarification of the concept.
Method
A consecutive series of patients were treated by PSS for their CRLMs, either by resection
or intra-operative ablation (IOA), whenever possible a one-stage surgery and minimal
usage of portal vein embolization. Post-operative complications were the primary endpoint
with a special focus on post-operative liver failure.
Results
Three hundred and eighty-seven patients underwent a PSS out of which 328 patients
received a median of 9 pre-operative cycles of chemotherapy. One hundred and twenty-eight
patients had a major resection, combined with IOA in 137 patients and IOA alone in
50 cases. The 5yr-overall survival was 50.3%. There was no difference in post-operative
complications between minor and major resections, validating our PSS definition based
on the Tumor burden/Healthy liver ratio and not just the retrieved volume.
Conclusions
PSS is defined as a high ratio of tumoral burden per specimen retrieved while favoring
one-stage surgery approach. Our series, using combined resections and IOAs, matches
this definition well. Furthermore, complications were correlated neither to chemotherapy
nor to liver-induced toxicities, contrary to extended hepatectomies.
Keywords
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Article info
Publication history
Published online: October 16, 2017
Accepted:
October 3,
2017
Received in revised form:
September 22,
2017
Received:
September 12,
2017
Identification
Copyright
© 2017 Published by Elsevier Ltd.
