Multiple Minor Hepatectomies Versus Major or Extended Hepatectomies for Colorectal Liver Metastases.

Multiple Minor Hepatectomies Versus Major or Extended Hepatectomies for Colorectal Liver Metastases. A Propensity Score-matched Dual-institution Analysis.

The performance of multiple minor hepatectomies (MMH) instead of major hepatectomies (MH) in patients with colorectal liver metastases (CLM) is object of debate. We build a study, using the propensity score matched analysis, to compare the short- and long-term outcome of the tow groups of patients.

Study Overview

• Status: Completed
• Conditions: Colon Cancer; Colorectal Liver Metastases
• Intervention / Treatment: Procedure: Hepatectomy

Detailed Description

The aim of this study is to investigate the outcome of patients with colorectal liver metastases (CLM) undergoing multiple minor hepatectomies (MMH) instead of major hepatectomies (MH). Indeed, the performance of MMH versus MH in patients with CLM is object of debate. For this purpose, the databases at two independent institutions were retrospectively reviewed. To control for confounding variable distributions, a propensity score-matched analysis 1:1 was performed, and the nearest neighbor-matching method with caliper distance of 0.01 was used. Among 554 patients, 110 patients undergoing MMH and 110 undergoing MH were matched. They were similar in baseline characteristics, comorbidities, features of the primary tumors, and CLM. Primary outcomes were short- and long-term outcome.

• Study Type: Observational
• Enrollment (Actual): 554

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients with colorectal liver metastases (CLM) that underwent hepatectomy.

Description

Inclusion Criteria:

• Diagnosis of CLM

Exclusion Criteria:

• Uncertain diagnosis
• Lost at follow-up

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Major hepatectomy (MH); Patients who underwent MH for CLM instead of multiple minor hepatectomy (MMH)	Procedure: Hepatectomy; Removal of a part of the liver; Other Names: Hepatic resection
Multiple minor hepatectomy (MMH); Patients who underwent MMH for CLM instead of MH	Procedure: Hepatectomy; Removal of a part of the liver; Other Names: Hepatic resection

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Number of postoperative complications after MH or MMH, graded based on the Dindo's classification (Dindo et al. Ann Surg 2004;240:205-13)	up to 90 days after surgery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Long-term outcome (overall and disease-free survival)	Typical follow-up after surgery (until death and evidence of recurrence)	10 years

Collaborators and Investigators

• Sponsor: University of Milan
• Collaborators: University of Bologna

Study record dates

Study Major Dates

• Study Start: January 1, 2005
• Primary Completion (Actual): November 1, 2014
• Study Completion (Actual): December 1, 2014

Study Registration Dates

• First Submitted: December 29, 2014
• First Submitted That Met QC Criteria: January 5, 2015
• First Posted (Estimate): January 6, 2015

Study Record Updates

• Last Update Posted (Estimate): January 6, 2015
• Last Update Submitted That Met QC Criteria: January 5, 2015
• Last Verified: January 1, 2015

More Information

Terms related to this study

• Keywords: hepatic resection; hepatectomy
• Additional Relevant MeSH Terms: Digestive System Diseases; Pathologic Processes; Neoplasms; Neoplasms by Site; Digestive System Neoplasms; Liver Diseases; Neoplastic Processes; Neoplasm Metastasis; Liver Neoplasms
• Other Study ID Numbers: MajorVsMinorHepatectomy