1282 Comparing Overall Survival and Oncological Recurrence in Laparoscopic and Open Hepatectomy for Colorectal Cancer Metastases: A Systematic Review
S F Dogan- Surgery
Abstract
Aim
The use of laparoscopic surgery (LS) for liver resection has risen exponentially and is competing, in popularity, with open surgery (OPS). The aim of this study is to compare the oncological recurrence and overall survival of LS and OPS approaches for colorectal cancer liver metastases resection.
Method
A literature search was conducted, in-line with the PRISMA guidelines, via Ovid and PubMed to collect manuscripts dated between 01/01/2010-01/03/2021. The outcomes of interest were recurrence-free survival (RFS), overall survival (OS), and negative resection margins (R0). A modified quality assessment was achieved using the Newcastle-Ottawa Score (NOS) and the ROBINS-I Tool, and the data was analysed using Stata 16.0.
Results
Overall, 10 studies were selected of which included a total of 1924 patients. The results show the 1-, 3- and 5-years RFS and OS for LS and OPS were comparable, therefore not significant. Whereas the R0 differences were small yet significant - the LS group had an 89.9% R0 (95% CI: 87% to 92.8%) and for OPS was 85.4% (95% CI: 81% to 88.9%), Z – score of 1.6550, p = 0.0490 (p < 0.05). Even though the results are not significant for RFS and OS, LS is preferable for patients in improving the quality of life in the long-term.
Conclusions
There is little difference between OPS and LS methods as it pertains to the quality of life. With LS being less invasive and having marginally better results, doctors should consider prioritising LS for patients with colorectal cancer liver metastasis as an alternative to OPS.