The impact of multivisceral liver resection on short- and long-term outcomes of patients with colorectal liver metastasis: A systematic review and meta-analysis.
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ABSTRACT:
SUBMITTER: Silveira Junior S
PROVIDER: S-EPMC9489954 | biostudies-literature | 2022
REPOSITORIES: biostudies-literature
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The impact of multivisceral liver resection on short- and long-term outcomes of patients with colorectal liver metastasis: A systematic review and meta-analysis.
Silveira Júnior Sérgio S Tustumi Francisco F Magalhães Daniel de Paiva DP Jeismann Vagner Birk VB Fonseca Gilton Marques GM Kruger Jaime Arthur Pirola JAP Coelho Fabricio Ferreira FF Herman Paulo P
Clinics (Sao Paulo, Brazil) 20220916
The impact of Multivisceral Liver Resection (MLR) on the outcome of patients with Colorectal Liver Metastasis (CRLM) is unclear. The present systematic review aimed to compare patients with CRLM who underwent MLR versus standard hepatectomy regarding short- and long-term outcomes. MLR is a feasible procedure but has a higher risk of major complications. MLR did not negatively affect long-term survival, suggesting that an extended resection is an option for potentially curative treatment for sele ...[more]
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Project description:BACKGROUND:Numerous reports regarding sarcopenia have focused on the quantity of skeletal muscle. In contrast, the impact of the quality of skeletal muscle has not been well investigated. METHODS:A retrospective analysis of 115 patients who underwent initial hepatectomy for colorectal liver metastasis between January 2009 and December 2016 in our hospital was performed. Intramuscular adipose tissue content (IMAC) was used to evaluate the quality of skeletal muscle by analysing computed tomography (CT) images at the level of the umbilicus. The impact of poor skeletal muscle quality on short-term and long-term outcomes after hepatectomy for colorectal liver metastasis was analysed. RESULTS:Patients were divided into two groups (high IMAC and normal IMAC) according to their IMAC values, and their backgrounds were compared. There were no significant differences in most factors between the two groups. However, both body mass index (P = 0.030) and the incidence of postoperative complications of Clavien-Dindo grade 3 or worse (P = 0.008) were significantly higher in the high-IMAC group. In multivariate analyses, an operative blood loss > 600?ml (P = 0.006) and high IMAC (P = 0.008) were associated with postoperative complications of Clavien-Dindo grade 3 or worse. Overall survival and recurrence-free survival were significantly lower (P < 0.001 and P = 0.045, respectively) in the high-IMAC group than in the normal IMAC group. In multivariate analyses for poor overall survival, high IMAC was associated with poor overall survival (P < 0.001). CONCLUSIONS:IMAC is a prognostic factor for poor short- and long-term outcomes in patients with colorectal liver metastasis.
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Project description:UnlabelledWe aimed to establish whether the presence of hepatic steatosis influences outcome after resection of colorectal liver metastases (CLM).Patients and methodsPatients operated between 1990 and 2014 were divided into four groups based on the degree of hepatic steatosis. The association between hepatic steatosis and outcome was analyzed, using a multivariate and a propensity score case-match analysis.ResultsNo significant differences were observed between patients with and without steatosis in either mortality or morbidity in the complete series or after matching (3.2% vs. 3.5%/p = 0.845) (32.3% vs 31.4%/p = 0.802). Five-year survival in patients with and without steatosis were 56.5% and 46.5% respectively (p = 0.046). The steatosis had a significant protective effect in the univariate analysis (HR (95% CI) = 0.78 (0.62-0.99) p = 0.048), and was close to significance in the multivariate analysis (HR (95%) = 0.81 (0.63-1.03) p = 0.089). No significant differences were seen with regard to liver recurrence.ConclusionsThe presence of steatosis does not predict short-outcome after resection of CLM, but appears to be a favorable prognostic factor for survival. This protective effect does not depend on a decrease in liver recurrence.
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