For patients with metastatic colorectal cancer who have resectable liver metastases, survival outcomes at five years do not differ significantly for treatment with laparoscopic versus open liver resection, according to a study published online Nov. 17 in the Annals of Internal Medicine.
Davit L. Aghayan, M.D., from the University of Oslo in Norway, and colleagues examined long-term oncologic outcomes after laparoscopic versus open liver resection in a single-center trial involving 280 patients with resectable colorectal liver metastases. Patients were randomly assigned to either laparoscopic surgery (133 patients) or open surgery (147 patients).
The researchers found that the rates of five-year survival were 54 and 55 percent in the laparoscopic and open groups, respectively, at a median follow-up of 70 months (hazard ratio, 0.93; 95 percent confidence interval, 0.67 to 1.30; P = 0.67). In the laparoscopic and open groups, the rates of five-year recurrence-free survival were 30 and 36 percent, respectively (hazard ratio, 1.09; 95 percent confidence interval, 0.80 to 1.49; P = 0.57).
“A limitation of our trial is that it was not powered to detect differences in secondary end points and was not designed to address a noninferiority hypothesis for survival outcomes,” the authors write. “Therefore, small-to-moderate differences in survival outcomes (in favor of either laparoscopic or open surgery) cannot be excluded, and clinicians should be aware of this when interpreting our results.”