Evolution of Surgical Treatment of Colorectal Liver Metastases in the Real World: Single Center Experience in 1212 Cases

摘要

The main purpose of this study is to evaluate the evolution of surgical treatment of CRLM within a referral center, comparing three consecutive time periods. Trends will be assessed with a specific focus on technical issues, such as the adoption of the laparoscopic approach and strategies to induce liver hypertrophy, as well as oncological issues, such as the variation in characteristics of the disease (Clinical Risk Score and extrahepatic metastases) and long term results. The secondary endpoint will be to evaluate, through uni- and multivariate analysis, the predictive factors for inclusion to a minimally invasive approach (technical issue) and the predictive factors of overall survival (oncological issue). Results demonstrated that, within the study period, the cultural background, the maturation of technical expertise and the consolidation of the multidisciplinary team have resulted in safe expansion of the possibility to offer a curative opportunity to patients, while continuously implementing into clinical practice evidence provided by the literature.