Objective: To evaluate the results of this type of liver surgery performed at a specialised regional hospital in comparison with the operation performed at a university medical centre (UMC).
Design: Prospective study at 2 hospitals.
Methods: All patients with colorectal liver metastasis who had undergone a partial liver resection and/or radiofrequency ablation (RFA) at Amphia Hospital or at the Academic Medical Centre - University of Amsterdam (AMC) from January 2005-June 2011 were included. Data on patient characteristics, type of operation, pathology results and (disease-free) survival were collected. The primary outcome measures were surgical complications and survival.
Results: A total of 232 patients were included. No difference in patient characteristics between centres was identified. At the AMC, 121 patients (98.4%) had undergone a resection; 6 in combination with RFA. Two patients (1.6%) had only undergone RFA. At Amphia Hospital, 85 patients (78%) had undergone a resection; 30 in combination with RFA. In 24 patients (22%), only RFA was performed. There was significant difference in the type of treatment (p < 0.01). Not significantly different between centres were the average lengths of hospital stays, surgical complications and recurrence rates. After resection, no significant differences in the 1- and 3-year (disease-free) survival rates were found between the centres. At Amphia Hospital, the overall survival at 1, 3 and 5 years was 86, 47 and 29%, respectively. These rates were significantly better at AMC with 91, 78 and 53%, respectively (p < 0.05). The difference in (disease-free) survival for the entire group of patients can be explained by the more frequent performance of RFA at Amphia Hospital.
Conclusions: Postoperative morbidity, mortality and survival rates after liver surgery obtained from a specialised regional hospital are similar to results obtained from a UMC.