Survival Advantage of Laparoscopic Versus Open Resection For Colorectal Liver Metastases: A Meta-analysis of Individual Patient Data From Randomized Trials and Propensity-score Matched Studies.

Annals of Surgery
Nicholas L SynBrian K P Goh

Abstract

To perform an individual participant data meta-analysis using randomized trials and propensity-score matched (PSM) studies which compared laparoscopic versus open hepatectomy for patients with colorectal liver metastases (CLM). Randomized trials and PSM studies constitute the highest level of evidence in addressing the long-term oncologic efficacy of laparoscopic versus open resection for CLM. However, individual studies are limited by the reporting of overall survival in ways not amenable to traditional methods of meta-analysis, and violation of the proportional hazards assumption. Survival information of individual patients was reconstructed from the published Kaplan-Meier curves with the aid of a computer vision program. Frequentist and Bayesian survival models (taking into account random-effects and nonproportional hazards) were fitted to compare overall survival of patients who underwent laparoscopic versus open surgery. To handle long plateaus in the tails of survival curves, we also exploited "cure models" to estimate the fraction of patients effectively "cured" of disease. Individual patient data from 2 randomized trials and 13 PSM studies involving 3148 participants were reconstructed. Laparoscopic resection was associ...Continue Reading

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Citations

Nov 18, 2020·Journal of Hepato-biliary-pancreatic Sciences·Masakazu YamamotoTadahiro Takada
Jan 12, 2021·Zeitschrift für Gastroenterologie·Felix BeckerBenjamin Struecker
Jan 16, 2021·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·Stefan Heinrich, Hauke Lang
Jan 23, 2021·International Journal of Molecular Sciences·Shuya YanoRobert M Hoffman
Mar 30, 2021·The British Journal of Surgery·Darren ChuaBrian K P Goh
Apr 7, 2021·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Caelán M HaneyFelix Nickel
Dec 20, 2020·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·Parbatraj RegmiFu-Yu Li
May 30, 2021·Lung Cancer : Journal of the International Association for the Study of Lung Cancer·Viola W ZhuMisako Nagasaka
Jul 30, 2021·World Journal of Gastrointestinal Oncology·Emily TaillieuMathieu D'Hondt
Oct 5, 2021·Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society·Sivesh K KamarajahSteven A White

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