Q2 Committee: David Geller, Giulio Belli, Bjørn Edwin, Paulo Herman, Daniel Cherqui

Q2 Committee: David Geller, Giulio Belli, Bjørn Edwin, Paulo Herman, Daniel Cherqui

Q2: What are the comparative long term outcomes of LLR and OLR? (minor and major)

Recommendations:

1.  No RCT have been published to date comparing LLR to OLR

2.  The best data comes from case-cohort matched studies comparing LLR to OLR for HCC or limited mCRC.

3.  With LLR for cancer, there are no reports or trocar or peritoneal seeding.

4.  For HCC, 18 comparative studies have been published comparing LLR to OLR that provide either 3 year or 5 year disease-free survival or overall survival. None of the comparative studies showed inferiority for LLR for 3 year- or 5 year- DFS or OS for HCC.

5.  For mCRC, 11 comparative studies have been published comparing LLR to OLR for limited mCRC (1 or 2 hepatic metastases). All of the studies show comparable 3 year- or 5 year- DFS or OS.

6.  Hence, the aggregate data shows equivalent long-term overall survival comparing LLR to OLR for HCC or limited mCRC.

7.  Given the equivalent oncologic outcomes, then any short-term benefits reported for LLR compared to OLR under CQ1 justify and favor LLR since there is no compromise of long-term cancer outcomes.

8.  LLR facilitates future liver surgery (transplant or resection) for recurrent tumor.

References

Reviews

1.  Nguyen KT, Gamblin TC, Geller DA. World review of laparoscopic liver resection – 2,804 patients. Ann Surg, 2009, 250:831-841.

2.  Buell JF, Cherqui D, Geller DA, et al. The International Position on Laparoscopic Liver Surgery: The Louisville Statement, 2008. Ann Surg. 2009; 250:825-830.

3.  Viganò L, Tayar C, Laurent A, Cherqui D. Laparoscopic liver resection: a systematic review. J Hepatobiliary Pancreat Surg. 2009; 16:410-21.

4.  Pulitanò C, Aldrighetti L. The current role of laparoscopic liver resection for the treatment of liver tumors. Nat Clin Pract Gastroenterol Hepatol 2008;5:648-54.

5.  Nguyen KT, Marsh JW, Tsung A, Steel JL, Gamblin TC, Geller DA. Comparative benefits of laparoscopic versus open hepatic resection: a critical appraisal. Arch Surg, 2011; 146:348-56.

6.  Reddy SK, Tsung A, Geller DA. Laparoscopic liver resection. World J Surg. 2011; 35:1478-86.

7.  Imura S, Shimada M, Utsunomiya T, Morine Y, Wakabayashi G, Kaneko H. Current status of laparoscopic liver surgery in Japan: results of a multicenter Japanese experience. Surg Today. 2013 Jul 26

8.  Tranchart H, Dagher I. Laparoscopic liver resection: A review. J Visc Surg. 2013: S1878-7886.

9.  Lin NC, Nitta H, Wakabayashi G. Laparoscopic major hepatectomy: a systematic literature review and comparison of 3 techniques. Ann Surg. 2013; 257:205-13.

HCC comparative series

1.  Shimada M, Hashizume M, Maehara S, et al. Laparoscopic hepatectomy for hepatocellular carcinoma. Surg Endosc 2001; 15:541-544

2.  Laurent A, Cherqui D, Lesurtel M, Brunetti F, Tayar C, Fagniez PL. Laparoscopic liver resection for subcapsular hepatocellular carcinoma complicating chronic liver disease. Arch Surg. 2003 Jul; 138:763-9.

3.  Kaneko H, Takagi S, Otsuka Y, Tsuchiya M, Tamura A, Katagiri T, Maeda T, Shiba T. Laparoscopic liver resection of hepatocellular carcinoma. Am J Surg. 2005; 189:190-4.

4.  Cherqui D, Laurent A, Tayar C, et al. Laparoscopic liver resection for peripheral hepatocellular carcinoma in patients with chronic liver disease: midterm results and perspectives. Ann Surg 2006; 243:499-506.

5.  Belli G, Fantini C, D'Agostino A, Cioffi L, Langella S, Russolillo N, Belli A. Laparoscopic versus open liver resection for hepatocellular carcinoma in patients with histologically proven cirrhosis: short- and middle-term results. Surg Endosc. 2007; 21:2004-11.

6.  Lee KF, Cheung YS, Chong CN, Tsang YY, Ng WW, Ling E, Wong J, Lai PB. Laparoscopic versus open hepatectomy for liver tumours: a case control study. Hong Kong Med J. 2007 Dec; 13:442-8

7.  Chen, HY, CC Juan, Kerr CG. Laparoscopic liver surgery for patients with hepatocellular carcinoma. Ann Surg Oncol 2008;15:800-6.

8.  Cai XJ, Yang J, Yu H, Liang X, Wang YF, Zhu ZY, Peng SY. Clinical study of laparoscopic versus open hepatectomy for malignant liver tumors. Surg Endosc. 2008; 22:2350-6

9.  Belli G, Limongelli P, Fantini C, D'Agostino A, Cioffi L, Belli A, Russo G. Laparoscopic and open treatment of hepatocellular carcinoma in patients with cirrhosis. Br J Surg. 2009; 96:1041-8.

10.  Kaneko H, Tsuchiya M, Otsuka Y, et al. Laparoscopic hepatectomy for hepatocellular carcinoma in cirrhotic patients. J Hepatobiliary Pancreat Surg 2009;16:433-8.

11.  Sarpel U, Hefti MM, Wisnievsky JP, et al. Outcome for patients treated with laparoscopic versus open resection of hepatocellular carcinoma: case-matched analysis. Ann Surg Oncol 2009; 16:1572-7.

12.  Lai EC, Tang CN, Yang GP, Li MK. Minimally invasive surgical treatment of hepatocellular carcinoma: long-term outcome. World J Surg. 2009; 33:2150-4.

13.  Lai EC, Tang CN, Ha JP, Li MK. Laparoscopic liver resection for hepatocellular carcinoma: ten-year experience in a single center. Arch Surg 2009; 144:143-7.

14.  Endo Y, Ohta M, Sasaki A, eta l. A comparative study of the long-term outcomes after laparoscopy-assisted and open left lateral hepatectomy for hepatocellular carcinoma. Surg Laparosc Endosc Percutan Tech. 2009; 19:e171-4

15.  Dagher I, Belli G, Fantini C, Laurent A, Tayar C, Lainas P, Tranchart H, Franco D, Cherqui D. Laparoscopic hepatectomy for hepatocellular carcinoma: a European experience. J Am Coll Surg 2010; 211:16-23.

16.  Tranchart H, Di Giuro G, Lainas P et al. Laparoscopic resection for hepatocellular carcinoma: a matched-pair comparative study. Surg Endosc. 2010; 24:1170-6.

17.  Ker CG, Chen JS, Kuo KK, Chuang SC, Wang SJ, Chang WC, Lee KT, Chen HY, Juan CC. Liver Surgery for Hepatocellular Carcinoma: Laparoscopic versus Open Approach. Int J Hepatol. 2011:1-7.

18.  Truant S, Bouras AF, Hebbar M, Boleslawski E, Fromont G, Dharancy S, Leteurtre E, Zerbib P, Pruvot FR. Laparoscopic resection vs. open liver resection for peripheral hepatocellular carcinoma in patients with chronic liver disease: a case-matched study. Surg Endosc. 2011; 25:3668-77

19.  Lee KF, Chong CN, Wong J, Cheung YS, Wong J, Lai P. Long-term results of laparoscopic hepatectomy versus open hepatectomy for hepatocellular carcinoma: a case-matched analysis. World J Surg. 2011; 35:2268-74.

20.  Hu BS, Chen K, Tan HM, Ding XM, Tan JW. Comparison of laparoscopic vs open liver lobectomy(segmentectomy)for hepatocellular carcinoma. World J Gastroenterol. 2011;17:4725-8.

21.  Kim K-J, Jeong C-Y, Jeong S-H, et al. Laparoscopic Liver Resection for Hepatocellular Carcinoma. J Korean Surg Soc. 2011; 80:51.

22.  Cheung TT, Poon RTP, Yuen WK, et al. Long-Term Survival Analysis of Pure Laparoscopic Versus Open Hepatectomy for Hepatocellular Carcinoma in Patients With Cirrhosis. Annals of Surgery. 2013; 257:506–511.

23.  Kim H, Suh K-S, Lee K-W, et al. Long-term outcome of laparoscopic versus open liver resection for hepatocellular carcinoma: a case-controlled study with propensity score matching. Surgical Endoscopy. 2014; 28:950–960.

mCRC comparative series

24.  Mala T, Edwin B, Gladhaug I, Fosse E, Søreide O, Bergan A, Mathisen O. A comparative study of the short-term outcome following open and laparoscopic liver resection of colorectal metastases. Surg Endosc. 2002; 16:1059-63

25.  O'Rourke N, Shaw I, Nathanson L, Martin I, Fielding G. Laparoscopic resection of hepatic colorectal metastases. HPB. 2004; 6:230-5.

26.  Nguyen KT, Laurent A, Dagher I, Geller DA, Steel J, Thomas MT, Marvin M, Ravindra KV, Mejia A, Lainas P, Franco D, Cherqui D, Buell JF, Gamblin TC. Minimally invasive liver resection for metastatic colorectal cancer: a multi-institutional, international report of safety, feasibility, and early outcomes. Ann Surg. 2009; 250:842-848.

27.  Sasaki A, Nitta H, Otsuka K, Takahara T, Nishizuka S, Wakabayashi G. Ten-year experience of totally laparoscopic liver resection in a single institution. Br J Surg 2009; 96:274-279.

28.  Castaing D, Vibert E, Ricca L, Azoulay D, Adam R, Gayet B. Oncologic results of laparoscopic versus open hepatectomy for colorectal liver metastases in two specialized centers. Ann Surg. 2009; 250:849-55.

29.  Kazaryan AM, Marangos IP, Røsok BI, Rosseland AR, Villanger O, Fosse E, Mathisen O, Edwin B. Laparoscopic resection of colorectal liver metastases: surgical and long-term oncologic outcome. Ann Surg. 2010; 252:1005-12.

30.  Nguyen KT, Geller DA. Outcomes of laparoscopic hepatic resection for colorectal cancer metastases. J Surg Oncol. 2010; 102:975-7.

31.  Abu Hilal M, Underwood T, Zuccaro M, Primrose J, Pearce N. Short- and medium-term results of totally laparoscopic resection for colorectal liver metastases. Br J Surg. 2010; 97:927-3.

32.  Nguyen KT, Marsh JW, Tsung A, Steel JL, Gamblin TC, Geller DA. Comparative benefits of laparoscopic versus open hepatic resection: a critical appraisal. Arch Surg, 2011; 146:348-56.

33.  Cannon RM, Scoggins CR, Callender, GG, et al. Laparoscopic versus open resection of hepatic colorectal metastases. Surgery 2012; 152:567-573.

34.  Topal H, Tiek J, Aerts R, et al. Outcome of laparoscopic major liver resection for colorectal metastases. Surg Endosc 2012; 26:2451-2455.

35.  Hu, MG, Ou-yang CG, Zhao GD, et al. Outcomes of open versus laparoscopic procedure for synchronous radical resection of liver metastatic colorectal cancer: a comparative study. Surg Laparosc Endosc Percutan Tech 2012; 22:364-369.

36.  Guerron AD, Aliyev S, Agcaoglu O, et al. Laparoscopic versus open resection of colorectal liver metastasis. Surg Endosc 2013; 27:1138-1143.

37.  Cheung TT, Poon RT, Yuen WK, et al. Outcome of laparoscopic versus open hepatectomy for colorectal liver metastases. ANZ J Surg 2013; 83:847-52.

38.  Qiu J, Chen S, Pankaj P, et al. Laparoscopic hepatectomy for hepatic colorectal metastases - a retrospective comparative cohort analysis and literature review. PLoS One 2013; 8:e60153.

Meta-Analysis papers

1.  Simillis C, Constantinides VA, Tekkis PP, et al. Laparoscopic versus open hepatic resections for benign and malignant neoplasms--a meta-analysis. Surgery 2007;141: 203-211.

2.  Croome KP, Yamashita MH. Laparoscopic vs open hepatic resection for benign and malignant tumors: An updated meta-analysis. Arch Surg. 2010; 145:1109-18.

3.  Zhou YM, Shao WY, Zhao YF, et al. Meta-analysis of laparoscopic versus open resection for hepatocellular carcinoma. Dig Dis Sci 2011; 56:1937-1943.

4.  Yin Z, Fan X, Ye H, et al. Short- and long-term outcomes after laparoscopic and open hepatectomy for hepatocellular carcinoma: a global systematic review and meta-analysis. Ann Surg Oncol 2013; 20:1203-1215.

5.  Mirnezami R, Mirnezami AH, Chandrakumaran K, et al. Short- and long-term outcomes after laparoscopic and open hepatic resection: systematic review and meta-analysis. HPB (Oxford) 2011; 13:295-308.

6.  Li N, Wu YR, Wu B, et al. Surgical and oncologic outcomes following laparoscopic versus open liver resection for hepatocellular carcinoma: A meta-analysis. Hepatol Res 2012; 42:51-59.

7.  Fancellu A, Rosman AS, Sanna V, et al. Meta-analysis of trials comparing minimally-invasive and open liver resections for hepatocellular carcinoma. J Surg Res 2011; 171:e33-e45.

8.  Parks KR, Kuo YH, Davis JM, O' Brien B, Hagopian EJ. Laparoscopic versus open liver resection: a meta-analysis of long-term outcome. HPB (Oxford). 2014;16:109-18.

9.  Zhou Y, Xiao Y, Wu L, Li B, Li H. Laparoscopic liver resection as a safe and efficacious alternative to open resection for colorectal liver metastasis: a meta-analysis. BMC Surg. 2013 Oct 1;13:44.

10.  Rao A, Rao G, Ahmed I. Laparoscopic left lateral liver resection should be a standard operation. Surg Endosc. 2011;25(5):1603-10.

11.  Rao A, Rao G, Ahmed I. Laparoscopic or open liver resection? Let systematic review decide it. Am J Surg. 2012; 204:222-31.

12.  Rao AM, Ahmed I. Laparoscopic versus open liver resection for benign and malignant hepatic lesions in adults. Cochrane Database Syst Rev. 2013

13.  Mizuguchi T, Kawamoto M, Meguro M, Shibata T, Nakamura Y, Kimura Y, Furuhata T, Sonoda T, Hirata K. Laparoscopic hepatectomy: a systematic review, meta-analysis, and power analysis. Surg Today. 2011;41(1):39-47.

14.  Xiong JJ, Altaf K, Javed MA, Huang W, Mukherjee R, Mai G, Sutton R, Liu XB, Hu WM. Meta-analysis of laparoscopic vs open liver resection for hepatocellular carcinoma. World J Gastroenterol. 2012;18(45):6657-68

15.  Luo LX, Yu ZY, Bai YN. Laparoscopic Hepatectomy for Liver Metastases from Colorectal Cancer: A Meta-analysis. J Laparoendosc Adv Surg Tech A. 2014 Apr;24(4):213-22

16.  Wei M, He Y, Wang J, Chen N, Zhou Z, Wang Z. Laparoscopic versus open hepatectomy with or without synchronous colectomy for colorectal liver metastasis: a meta-analysis. PLoS One. 2014;9(1):e87461.

17.  Schiffman SC, Kim KH, Tsung A, Marsh JW, Geller DA. Laparoscopic versus open liver resection for metastatic colorectal cancer: A meta-analysis of 610 patients. Surgery, 2014, In press.

9

Q2: What are the comparative long term outcomes of LLR and OLR ?(minor and major)

Author / Year / Journal / # pts (n) / Study type / Tumor / Median F/U (mos) / Median DFS (mos) / Median OS (mos) / 3 yr DFS (%) / 5 yr DFS (%) / 3 yr OS (%) / 5 yr OS (%) / p values
LLR / OLR / LLR / OLR / LLR / OLR / LLR / OLR / LLR / OLR / LLR / OLR / LLR / OLR / LLR / OLR
Kim / 2014 / Surg Endo / 29 / 29 / Comparative / HCC / 48 / 60 / NA / NA / 62 / 61 / 54 / 40 / 100 / 92 / 92 / 88 / NS
Cheung / 2013 / Ann Surg / 32 / 64 / Comparative / HCC / NA / 79 / 29 / 92 / 71 / 73 / 50 / 55 / 44 / 88 / 73 / 77 / 57 / NS
Kobayashi / 2013 / Surg Endo / 56 / 27 / Comparative / HCC / 19 / 68 / NA / NA / 50 / 62 / NA / 100 / 100 / NA / NS
Ker / 2011 / Int J Hepat / 116 / 208 / Comparative / HCC / 94 / 94 / NA / NA / NA / NA / 70 / 76 / 62 / 72 / NS
Truant / 2011 / Surg Endo / 35 / 53 / Comparative / HCC / 36 / 36 / NA / NA / NA / 36 / 34 / NA / 70 / 46 / NS
Lee / 2011 / W J Surg / 33 / 50 / Comparative / HCC / 35 / 29 / NA / NA / 51 / 56 / 45 / 56 / 82 / 81 / 76 / 76 / NS
Hu / 2011 / W J Gastro / 30 / 30 / Comparative / HCC / NA / NA / NA / NA / NA / 76 / 77 / 50 / 53 / NS
Kim / 2011 / J Kor Surg / 26 / 29 / Comparative / HCC / 22 / 25 / NA / NA / NA / 57 / 56 / NA / NA / NS
Tranchart / 2010 / Surg Endo / 42 / 42 / Comparative / HCC / 30 / 35 / NA / NA / 61 / 54 / 46 / 37 / 74 / 73 / 60 / 47 / NS
Aldrighetti / 2010 / J Surg Onc / 16 / 16 / Comparative / HCC / 32 / 32 / 23 / 31 / 40 / 48 / NA / NA / NA / NA / NS
Belli / 2009 / Br J Surg / 54 / 125 / Comparative / HCC / 24 / 24 / 38 / - / 63 / - / 52 / 55 / NA / 67 / 63 / NA / NS
Sarpel / 2009 / AnnSurg Onc / 20 / 56 / Comparative / HCC / 24 / 18 / NA / NA / NA / NA / NA / 95 / 75 / NS
Endo / 2009 / Surg Lap ET / 41923 / Comparative / HCC / NA / NA / NA / NA / 24 / 19 / NA / 57 / 48 / NS
Lai / 2009 / Arch Surg / 25 / 33 / Comparative / HCC / 29 / 29 / NA / NA / 52 / 56 / NA / 60 / 60 / NA / NS
Cai / 2008 / Surg Endo / 31 / 31 / Comparative / HCC / NA / NA / 70 / 61 / NA / NA / 67 / 74 / 56 / 54 / NS
Kaneko / 2005 / Am J Surg / 30 / 28 / Comparative / HCC / NA / NA / NA / 45 / 50 / 31 / 29 / 80 / 77 / 61 / 62 / NS
Laurent / 2003 / Arch Surg / 13 / 13 / Comparative / HCC / NA / NA / NA / 56 / 54 / NA / 89 / 55 / NA / 0.04