Laparoscopic Versus Open Liver Resection for Colorectal Liver Metastases : An Individual Participant Data Meta-analysis of Four Randomized Clinical Trials.

Authors

Bram Olij, Gabriela Pilz da Cunha, Siân A Pugh, Mohammad Abu Hilal, Víctor Lopez-Lopez, Davit Aghayan, Roberto Brusadin, Robert S Fichtinger, Francesca Ratti, Christoph Kuemmerli, Jasper P Sijberden, Marc G Besselink, Roberto I Troisi, Lloyd Brandts, John N Primrose, Bjørn Edwin, Ricardo Robles-Campos, Ronald M van Dam, Åsmund A Fretland, LLR vs OLR IPDMA Collaborators

Published in

Annals of internal medicine. Oct 27, 2026. Epub Oct 27, 2026.

Abstract

Randomized clinical trials (RCTs) have compared laparoscopic liver resection (LLR) and open liver resection (OLR) for colorectal liver metastases (CRLM); however, long-term outcomes and subgroup effects have not been comprehensively evaluated.
To compare postoperative and long-term oncologic outcomes after LLR versus OLR for CRLM using individual participant data from RCTs.
PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched from database inception through March 2025 for RCTs comparing LLR and OLR for CRLM.
Eligible studies were RCTs comparing LLR and OLR for CRLM.
Individual participant data, including unpublished data, were obtained from trial investigators of all 4 published RCTs.
Analyses used a modified intention-to-treat approach and 1-stage individual participant data meta-analysis (IPDMA) with trial-adjusted regression models and g-computation to estimate standardized treatment effects across outcomes, with 95% CIs obtained by nonparametric bootstrap resampling. Prespecified subgroup analyses assessed heterogeneity of treatment effect for the primary outcome. A total of 761 patients were included (laparoscopic, n = 384; open, n = 377). Postoperative morbidity was lower in patients assigned to laparoscopic surgery compared with open surgery (19% vs. 27%). Among patients who received preoperative systemic therapy, morbidity did not differ between groups (25% vs. 24%). Ninety-day mortality was 1.8% after LLR and 0.8% after OLR. After a median follow-up of 93 months, overall survival and disease-free survival did not differ between groups.
Analyses were limited to variables available across all studies.
In this IPDMA of all published RCTs in the field, LLR for CRLM was associated with lower postoperative morbidity than OLR, with similar long-term oncologic outcomes.
None. (PROSPERO: CRD42024502655).

PMID:
42932884
Bibliographic data and abstract were imported from PubMed on 27 Oct 2026.

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