Evidence map›Paper›PMID 40795061›Full record

ArticleAnnals of surgery2026

Two-stage Hepatectomy Versus Liver Transplantation for Patients With Marginally Resectable Extensive Bilobar Colorectal Liver Metastases.

Yosuke Nakao, René Adam, Abdul Halim Nasser, Katsunori Imai, Nicolas Golse, Daniel Pietrasz, Oriana Ciacio, Gabriella Pittau, Chady Salloum, Masaaki Iwatsuki and 10 more

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Annals of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors.

Yosuke NakaoCentre Hépato-biliaire, AP-HP, Hôpital Universitaire Paul Brousse, Université Paris-Saclay, Villejuif, France.
René AdamCentre Hépato-biliaire, AP-HP, Hôpital Universitaire Paul Brousse, Université Paris-Saclay, Villejuif, France.
Abdul Halim NasserCentre Hépato-biliaire, AP-HP, Hôpital Universitaire Paul Brousse, Université Paris-Saclay, Villejuif, France.
Katsunori ImaiDepartment of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Nicolas GolseCentre Hépato-biliaire, AP-HP, Hôpital Universitaire Paul Brousse, Université Paris-Saclay, Villejuif, France.
Daniel PietraszCentre Hépato-biliaire, AP-HP, Hôpital Universitaire Paul Brousse, Université Paris-Saclay, Villejuif, France.
Oriana CiacioCentre Hépato-biliaire, AP-HP, Hôpital Universitaire Paul Brousse, Université Paris-Saclay, Villejuif, France.
Gabriella PittauCentre Hépato-biliaire, AP-HP, Hôpital Universitaire Paul Brousse, Université Paris-Saclay, Villejuif, France.
Chady SalloumCentre Hépato-biliaire, AP-HP, Hôpital Universitaire Paul Brousse, Université Paris-Saclay, Villejuif, France.
Masaaki IwatsukiDepartment of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Eric VibertCentre Hépato-biliaire, AP-HP, Hôpital Universitaire Paul Brousse, Université Paris-Saclay, Villejuif, France.
Antonio Sa CunhaCentre Hépato-biliaire, AP-HP, Hôpital Universitaire Paul Brousse, Université Paris-Saclay, Villejuif, France.
Francis LéviÉquipe Chronothérapie, Cancer et Transplantation, Université Paris Saclay, Gif-sur-Yvette, France.
Michel DucreuxDepartment of Medical Oncology, Gustave Roussy, University of Paris-Saclay, Villejuif, France.
Maximiliano GelliDepartment of Anaesthesia, Surgery and Interventional Radiology, Gustave Roussy Hospital, University of Paris-Saclay, Villejuif, France.
Maïte LewinÉquipe Chronothérapie, Cancer et Transplantation, Université Paris Saclay, Gif-sur-Yvette, France.
Hideo BabaDepartment of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Daniel CherquiCentre Hépato-biliaire, AP-HP, Hôpital Universitaire Paul Brousse, Université Paris-Saclay, Villejuif, France.
Daniel AzoulayCentre Hépato-biliaire, AP-HP, Hôpital Universitaire Paul Brousse, Université Paris-Saclay, Villejuif, France.
Marc-Antoine AllardCentre Hépato-biliaire, AP-HP, Hôpital Universitaire Paul Brousse, Université Paris-Saclay, Villejuif, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare outcomes after two-stage hepatectomy (TSH) or liver transplantation (LT) in patients with extensive bilobar colorectal liver metastases (CRLM).

backgroundGiven the high rate of intrahepatic recurrence after TSH in patients with resectable but extensive bilobar CRLM, LT may be an alternative option. However, studies comparing TSH for potentially resectable patients to LT for unresectable ones are lacking.

methodsWe compared oncological outcomes of consecutive patients who underwent TSH for extensive bilobar CRLM (resection group, n=32) without extrahepatic disease with those of all patients who underwent LT for unresectable liver-only CRLM (LT group, n=19) at a single center within the 2016 to 2023 period. Results were analysed both in intention to treat and in per protocol. Propensity score matching (PSM) was used to refine the comparability of both groups.

resultsThe baseline and biological tumor characteristic of both groups were comparable except for unresectability and higher number of lesions in the LT group. Overall survival (OS), recurrence-free survival (RFS), and time to surgical failure (TSF) in the LT group were all significantly better than those in the TSH group (5-year OS: 84% vs 32%, P =0.003, 5-year RFS: 24% vs 0%, P =0.0001, 5-year TSF: 61% vs 7.7%, P <0.0001). Multivariable analysis revealed that left primary sidedness [hazard ratio (HR): 0.38, P =0.049] and LT (HR: 0.20, P =0.01) were independent prognostic factors of favorable OS. These results were confirmed after PSM.

conclusionsOur results suggest that LT might achieve better outcomes than TSH in patients with extensive bilobar but resectable liver-only CRLM.

Indexed as

Colorectal NeoplasmsHepatectomyLiver NeoplasmsLiver TransplantationAgedFemaleHumansMaleMiddle AgedPropensity ScoreRetrospective StudiesSurvival RateTreatment Outcomeextensive bilobar colorectal liver metastasesliver transplantationtwo-stage hepatectomy

Identifiers

PMID40795061

What OpenQuestion holds

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Registered trials

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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.