Oncological outcomes of laparoscopic surgery of liver metastases: a single-centre experience

Federica Cipriani, Majd Rawashdeh, Mohamed Ahmed, Thomas Armstrong, Neil W. Pearce, Mohammad Abu Hilal

In the era of multimodal management of liver metastases, surgical resection remains the only curative option, with open approach still being referred to as the standard of care. Currently, the feasibility and benefits of the laparoscopic approach for liver resection have been largely demonstrated. However, its oncologic adequacy remains to be confirmed. The aim of this study is to report the oncological results of laparoscopic liver resection for metastatic disease in a single-centre experience. A single-centre database of 413 laparoscopic liver resections was reviewed and procedures for liver metastases were selected. The assessment of oncologic outcomes included analysis of minimal tumour-free margin, R1 resection rate and 3-year survival. The feasibility and safety of the procedures were also evaluated through analysis of perioperative outcomes. The study comprised 209 patients (294 procedures). Colorectal liver metastases were the commonest indication (67.9 %). Fourteen patients had conversion (6.7 %) and oncological concern was the commonest reason for conversion (42.8 %). Median tumour-free margin was 10 mm and complete radical resections were achieved in 211 of 218 curative-intent procedures (96.7 %). For patients affected by colorectal liver metastases, 1- and 3-year OS resulted 85.9 and 66.7 %. For patients affected by neuroendocrine liver metastases, 1- and 3-year OS resulted 93 and 77.8 %. Among the patients with metastases from other primaries, 1- and 3-year OS were 83.3 and 70.5 %. The laparoscopic approach is a safe and valid option in the treatment of patients with metastatic liver disease undergoing curative resection. It does offer significant perioperative benefits without compromise of oncologic outcomes.