The impact of tumor location on oncologic outcomes in laparoscopic parenchymal sparing resection of colorectal liver metastases.

BACKGROUND

Laparoscopic liver resection (LLR) of colorectal liver metastases (CRLM) was shown to be feasible with reduced morbidity, shorter length of stay, and similar oncologic results when compared to open liver resection (OLR). However, no study to date looked at the rate of R1 resection according to tumor location.

METHODS

Patients who underwent parenchymal-sparing LLR of CRLM at our institution between January 2015 and December 2022 were included. The respective data was collected with a focused interest on tumor location. Resections were classified in two groups according to whether margins were negative (R0) or positive (R1). Data was compared and the rate of positive margins was evaluated according to tumor location.

RESULTS

A total of 502 resections were performed of which 119 (23.7%) were R1. The highest rate was found in segment I (48.3%), followed by segments II (37.3%), VII (26.5%), and IVa (25.7%). The lowest rate was identified in segment IVb (14%), followed by segments III (14.1%), VI (18.4%), V (20%), and VIII (20.8%).

CONCLUSION

LLR from segments I and II carry the highest risk of R1 resection. An in-depth investigation is required to determine if OLR provides an advantage over LLR for CRLM in specific locations.