Chirurgische behandeling van colorectale levermetastasen in een perifeer en een academisch ziekenhuis

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). Prospective study at 2 hospitals. 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. 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. Postoperative morbidity, mortality and survival rates after liver surgery obtained from a specialised regional hospital are similar to results obtained from a UMC