SynthesisHPB : the official journal of the International Hepato Pancreato Biliary Association2013
A systematic review of two-stage hepatectomy in patients with initially unresectable colorectal liver metastases.
Synthesis in HPB : the official journal of the International Hepato Pancreato Biliary Association, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 75 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
75 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Pooled it
- Trial
- ALPPS Improves Resectability Compared With Conventional Two-stage Hepatectomy in Patients With Advanced Colorectal Liver Metastasis: Results From a Scandinavian Multicenter Randomized Controlled Trial (LIGRO Trial).Annals of surgery · 2018Trial
- Associated Radiofrequency Ablation and Portal Vein Ligation for Staged Hepatectomy Compared to Portal Vein Ligation Induces Prolonged and Enhanced Liver Regenerative Response.European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes · 2026Article
- Liver hypertrophy techniques: a position paper from the Italian Group of Regenerative and Occlusive Worldwide-used techniques of hepatic Hypertrophy (I GROWtoH).Updates in surgery · 2025Article
- Modern therapeutic approaches for hepatic tumors: progress, limitations, and future directions.Discover oncology · 2025Review
- New trends in surgery for colorectal liver metastasis.Annals of gastroenterological surgery · 2024Review
- Review
- Review
- Extended Right Hepatectomy following Clearance of the Left Liver Lobe and Portal Vein Embolization for Curatively Intended Treatment of Extensive Bilobar Colorectal Liver Metastases: A Single-Center Case Series.Current oncology (Toronto, Ont.) · 2024Article
- Article
- Two-stage hepatectomy in resection of colorectal liver metastases - a single-institution experience with case-control matching and review of the literature.Radiology and oncology · 2023Review
- Right-sided ALPPS after preoperative emergency embolization of the right hepatic artery: case report with a favorable anatomy.Journal of surgical case reports · 2023Article
- Failure of enhanced recovery after surgery in liver surgery: a systematic review and meta analysis.Frontiers in medicine · 2023Review
- Portal vein embolization failure: Current strategies and future perspectives to improve liver hypertrophy before major oncological liver resection.World journal of gastrointestinal oncology · 2022Review
- All-trans retinoic acid inhibits the malignant behaviors of hepatocarcinoma cells by regulating ferroptosis.Genes & diseases · 2022Article
- Parenchyma-Sparing Liver Resection or Regenerative Liver Surgery: Which Way to Go?Medicina (Kaunas, Lithuania) · 2022Review
- Precision surgery for colorectal liver metastases: Current knowledge and future perspectives.Annals of gastroenterological surgery · 2022Review
- Systemic Therapy and Its Surgical Implications in Patients with Resectable Liver Colorectal Cancer Metastases. A Report from the Western Canadian Gastrointestinal Cancer Consensus Conference.Current oncology (Toronto, Ont.) · 2022Article
15 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesSelected patients with unresectable colorectal liver metastases (CLM) may be rendered resectable using the two-stage hepatectomy (TSH) approach. This review was conducted with the aim of collating and evaluating published evidence for TSH in patients with initially unresectable CLM.
methodsSearches of the MEDLINE and EMBASE databases were undertaken to identify studies of TSH in patients with initially unresectable CLM. Studies were required to focus on the perioperative treatment regimen, operative strategy, morbidity, technical success and survival outcomes.
resultsTen observational studies were reviewed. A total of 459 patients with initially unresectable CLM were selected for the first stage of TSH. Preoperative chemotherapy was used in 88% of patients and achieved partial and stable response rates of 59% and 39%, respectively. Postoperative morbidity and mortality after the first stage of TSH were 17% and 0.5%, respectively. Portal vein embolization (PVE) was used in 76% of patients. Ultimately, 352 of the initial 459 (77%) patients underwent the second stage of TSH. Major liver resection was undertaken in 84% of patients; the negative margin (R0) resection rate was 75%. Postoperative morbidity and mortality after the second stage of TSH were 40% and 3%, respectively. Median overall survival was 37 months (range: 24-44 months) in patients who completed both stages of TSH. In patients who did not complete both stages of TSH, median survival was 16 months (range: 10-29 months). The 3-year disease-free survival rate was 20% (range: 6-27%).
conclusionsTwo-stage hepatectomy is safe and effective in selected patients with initially unresectable CLM. Further studies are required to better define patient selection criteria for TSH and the exact roles of PVE and preoperative and interval chemotherapy.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.