O-L01 Learning curve for laparoscopic liver resection: does it affect survival in colorectal liver metastasis?

Abstract Background After Gagner introduced laparoscopic liver resection (LLR) in 1992, it was not until 2004 that the first series with more than ten major resections reported. Furthermore, a multicentre study by Allard et al., 2015 revealed laparoscopy only used 176 (6.7%) patients out of total 2620 treated for colorectal metastasis (CRLM). This lag time establishment LLR attributed to steep learning curve (LC) due technical complexity and caution about oncological safety. The aim this is assess if has affected survival CRLM. Methods All consecutive performed single surgeon between 2000–2019 were retrospectively analysed. RA-CUSUM conversion rate log regression analysis blood loss identify two phases curve. LC then applied CRLM subgroups compared outcomes. repeated propensity score-matched (PSM) groups Results A 286 included analysis. Combining results from identified distinct early phase (EP, n = 68) represented initial experience, late (LP, 218) increased competence introduction challenging cases. 192 (EPc 45, LPc 147). R0 achieved 93%; 100% EPc 90% (P .02). cohort median overall (OS) 60 months. recurrence-free (RFS) 16 5- year OS RFS 51% 33%, respectively. rates compromised curve; (HR: 0.78, 95% CI 0.51-1.2, p .26), 0.94, 95 % 0.64-1.37, p=.76). replicated after PSM. Conclusions In our development program can be without adverse effect on long-term