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Letter to the Editor|Articles in Press

Letter to the editor regarding “Liver Resection and role of Extended Histology (LiREcH study) in patients with multifocal colorectal cancer liver metastases”

  • Lei Zhang
    Affiliations
    Department of Liver Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
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  • Junwei Zhang
    Affiliations
    Department of Liver Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
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  • Yiyao Xu
    Correspondence
    Correspondence: Yiyao Xu, Department of Liver Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; 1 Shuaifuyuan, Dongcheng District, Beijing, China.
    Affiliations
    Department of Liver Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
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      We read with great interest the recently published article “Liver Resection and role of Extended Histology (LiREcH study) in patients with multifocal colorectal cancer liver metastases” by Hassan et al.
      • Bari H.
      • Thiyagarajan U.M.
      • Brown R.
      • Roberts K.J.
      • Chatzizacharias N.
      • Marudanayagam R.
      • et al.
      Liver Resection and role of Extended Histology (LiREcH study) in patients with multifocal colorectal cancer liver metastases.
      The authors have shown that the margin status was not related to the outcomes in patients with colorectal liver metastases. We support the use of non-anatomical resection (parenchyma-preserving hepatectomy) in patients with multifocal CRLM, by either laparoscopic or open surgery.
      • Giglio M.C.
      • Troisi R.I.
      Laparoscopic surgery for colorectal liver metastases: moving forward while keeping feet on the ground.
      ,
      • Guest R.V.
      • Soreide K.
      Addressing the variation in hepatic surgery for colorectal liver metastasis.
      Anatomic liver resection has the potential to reduce postoperative recurrence. This study only demonstrated that margin status does not affect local recurrence, however, the authors were not able to conclude whether recurrence was reduced in some patients in who it was possible to remove all tumors by hemihepatectomies, extended hemihepatectomies and associated liver partition and portal vein ligation for staged hepatectomy (ALPPS).
      • Okamoto K.
      • Uetake H.
      Current status of treatment for colorectal liver metastases in the United Kingdom.
      Therefore, we believe that the choice of surgical approach remains a matter of serious discussion for patients in whom all lesions can be removed by major hepatectomy.
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      References

        • Bari H.
        • Thiyagarajan U.M.
        • Brown R.
        • Roberts K.J.
        • Chatzizacharias N.
        • Marudanayagam R.
        • et al.
        Liver Resection and role of Extended Histology (LiREcH study) in patients with multifocal colorectal cancer liver metastases.
        HPB. 2021; 23: 1615-1622
        • Giglio M.C.
        • Troisi R.I.
        Laparoscopic surgery for colorectal liver metastases: moving forward while keeping feet on the ground.
        Hepatobiliary Surg Nutr. 2021; 10: 107-109
        • Guest R.V.
        • Soreide K.
        Addressing the variation in hepatic surgery for colorectal liver metastasis.
        Hepatobiliary Surg Nutr. 2021; 10: 103-106
        • Okamoto K.
        • Uetake H.
        Current status of treatment for colorectal liver metastases in the United Kingdom.
        Hepatobiliary Surg Nutr. 2021; 10: 116-118