Surgical and Oncologic Outcomes After Major Liver Surgery and Extended Hemihepatectomy for Colorectal Liver Metastases

Extensive liver surgery for colorectal liver metastases (CRLM) is frequently performed, but data on the outcomes of these complex surgical procedures are scarce. Here we report surgical and oncologic outcomes for 117 patients who underwent major liver surgery at a Dutch tertiary referral center. Major hepatic resection is associated with considerable postoperative morbidity and mortality, but it can provide significant long-term survival for patients with CRLM. Purpose: To determine the surgical and oncologic outcomes after major liver surgery for colorectal liver metastases (CRLM) at a Dutch University Hospital. Patients and Methods: Consecutive patients with CRLM who had undergone major liver resection, defined as >= 4 liver segments, between January 2000 and December 2015 were identified from a prospectively maintained database. Results: Major liver surgery was performed in 117 patients. Of these, 26 patients had undergone formal extended left or right hemihepatectomy. Ninety-day postoperative mortality was 8%. Major postoperative complications occurred in 27% of patients; these adverse events were more common in the extended hemihepatectomy group. Median disease-free survival was 11 months and median overall survival 44 months. Conclusion: Major liver surgery, including formal extended hemihepatectomy, is associated with significant operative morbidity and mortality but can confer prolonged overall survival for patients with CRLM.