Comparative analysis of parenchyma-sparing and anatomical resection methods in patients with colorectal cancer metastases to the liver using the pseudorandomization method

Aim. To identify the most appropriate surgical treatment method for patients with colorectal cancer metastases to the liver by means of a comparative analysis of immediate and long-term outcomes of anatomical and parenchyma-sparing liver resections.

Materials and methods. A retrospective analysis was conducted on the surgical treatment outcomes of 87 patients with colorectal cancer metastases to the liver who underwent surgery between 2008 and 2023. The analysis involved the pseudorandomization method to eliminate the influence of unaccounted factors and improve the statistical validity of the study. Age, sex, body mass index, synchronous nature of metastasis, number of metastases, tumor burden, etc. were used as variables to calculate the probability factor.

Results. A total of 87 observations were analyzed. Using the pseudorandomization method, 18 pairs of patients who underwent anatomical resection and parenchyma-sparing surgery were formed. The volume of blood loss was significantly lower in the parenchyma-sparing resection group (Me 250 ml; 187–525 ml) compared to the anatomical resection group (Me 850 ml; 315–2325 ml; p = 0.001). The duration of hospital stay after parenchymal-sparing resections accounted for 12 days, while after anatomical resections, it comprised 18 days (p = 0.031). The incidence of postoperative complications revealed no significant difference (p = 0.348). Positive resection margins were more frequently found in patients who underwent parenchyma-sparing surgery (16.7% and 5.6%, p = 0.289). The difference in overall and disease-free survival was not statistically significant.

Conclusion. Parenchymal-sparing liver resection is found to be a safe alternative to anatomical resection, allowing for the maximum preservation of liver tissue while achieving adequate oncological outcomes.

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