Comparing simultaneous versus staged resection in patients with synchronous colorectal liver metastases: case match study
INTRODUCTION: There is no consensus on the optimal timing of liver resection in patients with synchronous colorectal liver metastasis. METHODS: Patients undergoing hepatic resections between 2004- 2013 for synchronous colorectal liver metastases were analyzed from a prospectively maintained and...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2014
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/69804/ http://irep.iium.edu.my/69804/ http://irep.iium.edu.my/69804/ http://irep.iium.edu.my/69804/2/liver%20resection.pdf |
| Summary: | INTRODUCTION: There is no consensus on the optimal timing of
liver resection in patients with synchronous colorectal liver
metastasis.
METHODS: Patients undergoing hepatic resections between 2004-
2013 for synchronous colorectal liver metastases were analyzed
from a prospectively maintained and institutional review board
approved database. Patients who underwent simultaneous resection
of a colorectal primary and hepatic metastasis in a single operation
(Group I) were case-matched 1:1with patients who underwent
staged operation (Group II) according to age, sex, ASA classification, size of liver lesion and number of liver lesion.
RESULTS: 66 patients (33 Group I, 33 Group II) were matched
from a total cohort of 106 patients with synchronous colorectal
liver metastasis. The patients’ characteristics of both groups were
similar. 62% were male and the mean age was 55.511 years.
Blood loss and duration of surgery did not differ between
simultaneous resections and staged resection (p¼0.63; p¼0.14,
respectively). Perioperative complication rate were similar in both
groups (P¼0.70). There was no mortality. The median number
of in-hospital days during the course of treatment was 9 (4-23)
days in Group I and 6 (3-17) days in Group II (p <0.001). There
was no difference in 2 years disease free survival and overall survival
were found between Group I and Group II ( 30% and 34%, p¼
0.58; 67% and 62%, p¼0.86 respectively).
CONCLUSIONS: Simultaneous liver resections result in similar
short and long eterm outcomes as in patients undergoing sequential resections for synchronous colorectal cancer with comparable
metastatic disease burden. |
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