CLM: parenchymal-sparing resection OK for some patients

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  • Resectable colorectal liver metastases (CLMs) could be managed effectively with comparatively safer parenchymal-sparing/minor resection (PSH) in some patients, even those with multifocal disease, without reducing long-term survival.

Why this matters  

  • The trend has been away from major hepatectomy to PSH because of reduced morbidity and studies suggesting similar survival.

Key results 

  • With PSH vs major hepatectomy: Significantly fewer blood transfusions (P<.0001), fewer complications overall (29.0% vs 37.0%; P=.04), lower 90-d mortality (0.8% vs 3.8%; P=.03), and shorter hospital stay (P=.04).
  • OS and DFS did not differ between the 2 approaches (at 5 y, 28.5% with major hepatectomy vs 24.8% with PSH; adjusted HR for survival, 0.89).
  • No difference in neoadjuvant chemotherapy between groups.

Study design

  • 238 PSH patients case-matched with 238 major hepatectomy patients.
  • Funding: None disclosed.


  • Shift during the 10-y study period to more PSH.