title: Bilobar versus unilobar multiple colorectal liver metastases: a propensity score analysis of surgical outcomes and recurrence patterns.
abstract: BACKGROUND
  Bilobar multiple colorectal liver metastases (MCLM) are often considered incurable or associated with a poor prognosis even after R0 resection. This study was designed to compare the long-term outcomes and recurrence patterns after one-stage resection in patients with bilobar versus unilobar MCLM.
  
  
  METHODS
  The records of patients undergoing parenchymal-sparing intent hepatectomy between 1994 and 2015 were reviewed. Survival and recurrence patterns were analyzed by propensity score matching.
  
  
  RESULTS
  The study population included 140 patients: 81 patients with bilobar MCLM versus 59 patients with unilobar MCLM. In the propensity score matching analysis (bilobar, n = 35 vs. unilobar, n = 35), the short-term outcomes did not differ between the two groups. Five-year overall survival (54.8% in bilobar vs. 51.2% in unilobar; P = 0.388) and recurrence-free survival (28.5% in bilobar vs. 36.2% in unilobar; P = 0.261) also did not differ. No significant differences were found in liver-only recurrence (22.9% in bilobar vs. 25.7% in unilobar; P = 1.000) and other recurrence patterns.
  
  
  CONCLUSIONS
  The clearance of bilobar MCLM by one-stage resection of parenchymal-sparing intent provided comparable long-term survival to unilobar MCLM.
authors.affiliation: Department of Surgery, Ogaki Municipal Hospital, Ogaki, Gifu, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Fukami
authors.affiliation: Department of Surgery, Ogaki Municipal Hospital, Ogaki, Gifu, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kaneoka
authors.affiliation: Department of Surgery, Ogaki Municipal Hospital, Ogaki, Gifu, Japan.
authors.forename: Atsuyuki
authors.initials: A
authors.lastname: Maeda
authors.affiliation: Department of Surgery, Ogaki Municipal Hospital, Ogaki, Gifu, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Takayama
authors.affiliation: Department of Surgery, Ogaki Municipal Hospital, Ogaki, Gifu, Japan.
authors.forename: Takamasa
authors.initials: T
authors.lastname: Takahashi
authors.affiliation: Department of Surgery, Ogaki Municipal Hospital, Ogaki, Gifu, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Onoe
authors.affiliation: Department of Surgery, Ogaki Municipal Hospital, Ogaki, Gifu, Japan.
authors.forename: Masahito
authors.initials: M
authors.lastname: Uji
authors.affiliation: Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Wakai
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D057216:Propensity Score; D012307:Risk Factors; D015996:Survival Rate
keywords: Bilobar; Colorectal liver metastases; Hepatectomy; Propensity score; Recurrence