Comment: Laparoscopic versus open resection for colorectal liver metastases

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Published: 13 Jun 2019
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Prof Heinz-Josef Lenz - USC Norris Comprehensive Cancer Center, Los Angeles, USA

Prof Heinz-Josef Lenz talks to ecancer at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting about abstracts LBA3516 which covered laparoscopic versus open resection for colorectal liver metastases.

We all know that colon cancer is a very special disease because even when metastatic colon cancer can be cured, that’s not true for other cancers. So with more effective treatments we are getting into more and more situations where we will be able to go after metastatic disease with a curative intent in surgery.

So this study which was presented here showed for the first time that we don’t necessarily need open surgery but minimally invasive laparoscopically driven surgery to cure patients. The study was, of course, focused on the complication after surgery. After open surgery we would expect much more morbidity and mortality compared to a minimal invasive and they showed that clearly. The side effects were reduced by more than 50%.

The biggest question in the room was will this minimally invasive surgery be as effective in controlling recurrence of the disease and in overall survival. That was exactly shown here at ASCO, that there was no difference in recurrence free survival, no difference in overall survival but remaining significantly less problems after surgery such as infection, wound healing, recovery. So this will be an important step forward in order to integrate this minimal invasive surgery into a continuum of treatment options for patients with metastatic disease.

One of the issues that needs to be considered is that laparoscopic and minimally invasive surgery should be done in centres who have a lot of experience and not just starting out. So I can only encourage my colleagues in GI oncology to work with centres who have a lot of experience with laparoscopic, minimally invasive surgeries but that is now a wonderful new tool we can use, avoiding long hospitalisation and potential post-operative complications.