Comparison of Sequential, Delayed and Simultaneous Resection Strategies for Synchronous Colorectal Liver Metastases

Primary Tumour ◽

Term Survival ◽

Surgical Strategies ◽

Free Survival ◽

Simultaneous Resection ◽

Peking University ◽

Abstract Background: The present study aimed to compare the perioperative safety and long-term survival of patients with synchronous colorectal liver metastases undergoing sequential resection (SeR), delayed resection (DeR) and simultaneous resection (SiR). Methods: From January 2007 to December 2016, data from patients undergoing surgery at Peking University Cancer Hospital for synchronous colorectal liver metastases were retrospectively collected. The above three different surgical strategies were compared. Results: A total of 233 cases were included, with 49 in the SeR group, 98 in the DeR group and 86 in the SiR group. The incidence of severe complications was 26.7% in the SiR group, higher than that in the DeR group (11.2%, P = 0.007) and the SeR group (16.3%, P =0.166). The overall survival at 1 and 3 years in the SeR group (93.9% and 50.1%) was lower than that in the DeR group (94.9% and 64.8%, P = 0.019), but not significantly different from that in the SiR group (93.0% and 55.2%, P = 0.378). Recurrence-free survival at 1 and 3 years in the SeR group (22.4% and 18.4%) was lower than that in the DeR group (43.9% and 24.2%, P = 0.033) but not significantly different from that in the SiR group (31.4% and 19.6%, P = 0.275). Cox multivariate analysis indicated that T4, lymph node-positive primary tumour, liver metastases >30 mm and SiR (compared with DeR) were correlated with poor prognosis. Conclusion: Simultaneous resection has a relatively higher incidence of severe complications, and with a staged resection strategy, the prognosis of delayed resection was better than that of sequential resection.

Comparison of Sequential, Delayed and Simultaneous Resection Strategies for Synchronous Colorectal Liver Metastases

10.21203/rs.2.14066/v2 ◽

2019 ◽

Author(s):

Li-Jun Wang ◽

Hong-Wei Wang ◽

Ke-Min Jin ◽

Juan Li ◽

Bao-Cai Xing

Keyword(s):

Liver Metastases ◽

Primary Tumour ◽

Term Survival ◽

Surgical Strategies ◽

Free Survival ◽

Simultaneous Resection ◽

Peking University ◽

Abstract ABSTRACT Background: The present study aimed to compare the perioperative safety and long-term survival of patients with synchronous colorectal liver metastases undergoing sequential resection (SeR), delayed resection (DeR) and simultaneous resection (SiR). Methods: From January 2007 to December 2016, data from patients undergoing surgery at Peking University Cancer Hospital for synchronous colorectal liver metastases were retrospectively collected. The above three different surgical strategies were compared. Results: A total of 233 cases were included, with 49 in the SeR group, 98 in the DeR group and 86 in the SiR group. The incidence of severe complications was 26.7% in the SiR group, higher than that in the DeR group (11.2%, P = 0.007) and the SeR group (16.3%, P =0.166). The overall survival at 1 and 3 years in the SeR group (93.9% and 50.1%) was lower than that in the DeR group (94.9% and 64.8%, P = 0.019), but not significantly different from that in the SiR group (93.0% and 55.2%, P = 0.378). Recurrence-free survival at 1 and 3 years in the SeR group (22.4% and 18.4%) was lower than that in the DeR group (43.9% and 24.2%, P = 0.033) but not significantly different from that in the SiR group (31.4% and 19.6%, P = 0.275). Cox multivariate analysis indicated that T4, lymph node-positive primary tumour, liver metastases >30 mm and SiR (compared with DeR) were correlated with poor prognosis. Conclusion: Simultaneous resection has a relatively higher incidence of severe complications, and with a staged resection strategy, the prognosis of delayed resection was better than that of sequential resection.

Compare of Sequential, Delayed and Simultaneous Resection Strategies for Synchronous Colorectal Liver Metastases

10.21203/rs.2.14066/v1 ◽

2019 ◽

Author(s):

Li-Jun Wang ◽

Hong-Wei Wang ◽

Ke-Min Jin ◽

Juan Li ◽

Bao-Cai Xing

Keyword(s):

Liver Metastases ◽

Term Survival ◽

Surgical Strategies ◽

Free Survival ◽

Simultaneous Resection ◽

Peking University ◽

Synchronous Colorectal Liver Metastases ◽

Perioperative Safety

Abstract Background: The present study aimed to compare perioperative safety and long-term survival of patients with synchronous colorectal liver metastases receiving sequential resection (SeR), delayed resection (DeR) and simultaneous resection (SiR). Methods: From January 2007 to December 2016, data of patients receiving surgery at Peking University Cancer Hospital for synchronous colorectal liver metastases were retrospectively collected. The above three different surgical strategies were compared. Results: A total of 233 cases were included, with 49 in the SeR group, 98 in the DeR group and 86 in the SiR group. The incidence of severe complications was 26.7% in the SiR group, higher than that in the DeR group (11.2%, p=0.007) and the SeR group (16.3%, p=0.166). Overall survival at 1-year and 3-year in the SeR group (93.9% and 50.1%) was lower than the DeR group (94.9% and 64.8%, p=0.019), but not statistically different compared with the SiR group (93.0% and 55.2%, p=0.378). Recurrence-free survival at 1-year and 3-year in the SeR group (22.4% and 18.4%) was lower than the DeR group (43.9% and 24.2%, p=0.033), but not statistically different compared with the SiR group (31.4% and 19.6%, p=0.275). Cox multivariate analysis indicated that T4, lymph node positive primary tumor, liver metastases>30mm and selective sequential resection (compared with delayed resection) were correlated with poor prognosis. Conclusion: Simultaneous resection has a relatively higher incidence of severe complication, and when staged resection strategy was made, the prognosis of delayed resection was better than that of sequential resection.

Determinants of short- and long-term outcome in patients undergoing simultaneous resection of colorectal cancer and synchronous colorectal liver metastases

International Journal of Colorectal Disease ◽

10.1007/s00384-011-1339-9 ◽

2011 ◽

Vol 27 (3) ◽

pp. 363-369 ◽

Cited By ~ 12

Author(s):

C. S. D. Roxburgh ◽

C. H. Richards ◽

S. J. Moug ◽

A. K. Foulis ◽

D. C. McMillan ◽

...

Keyword(s):

Colorectal Cancer ◽

Liver Metastases ◽

Term Outcome ◽

Long Term Outcome ◽

Simultaneous Resection ◽

Synchronous Colorectal Liver Metastases ◽

Short And Long Term

Determinants of Long-Term Outcome in Patients Undergoing Simultaneous Resection of Synchronous Colorectal Liver Metastases

PLoS ONE ◽

10.1371/journal.pone.0105747 ◽

2014 ◽

Vol 9 (8) ◽

pp. e105747 ◽

Cited By ~ 10

Author(s):

Qi Lin ◽

Qinghai Ye ◽

Dexiang Zhu ◽

Ye Wei ◽

Li Ren ◽

...

Keyword(s):

Liver Metastases ◽

Term Outcome ◽

Long Term Outcome ◽

Simultaneous Resection ◽

PTU-265 Long term survival after the liver first approach for synchronous colorectal liver metastases: a single centre propensity score case-matched analysis

Gut ◽

10.1136/gutjnl-2015-309861.380 ◽

2015 ◽

Vol 64 (Suppl 1) ◽

pp. A178.2-A178

Author(s):

FK Welsh ◽

K Chandrakumaran ◽

TG John ◽

AB Cresswell ◽

M Rees

Keyword(s):

Propensity Score ◽

Liver Metastases ◽

Single Centre ◽

Term Survival ◽

Long Term Survival ◽

Determinants of long-term outcome in patients undergoing simultaneous resection of synchronous colorectal liver metastases.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.15_suppl.e14593 ◽

2014 ◽

Vol 32 (15_suppl) ◽

pp. e14593-e14593

Author(s):

Jianmin Xu ◽

Qi Lin ◽

Dexiang Zhu

Keyword(s):

Liver Metastases ◽

Term Outcome ◽

Long Term Outcome ◽

Simultaneous Resection ◽

SURGICAL OUTCOMES AND PROGNOSTIC FACTORS IN PATIENTS WITH SYNCHRONOUS COLORECTAL LIVER METASTASES

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032014000100002 ◽

2014 ◽

Vol 51 (1) ◽

pp. 4-9 ◽

Cited By ~ 1

Author(s):

Rafael FONTANA ◽

Paulo HERMAN ◽

Vincenzo PUGLIESE ◽

Marcos Vinicius PERINI ◽

Fabricio Ferreira COELHO ◽

...

Keyword(s):

Colorectal Cancer ◽

Prognostic Factors ◽

Liver Metastasis ◽

Liver Metastases ◽

Disease Free Survival ◽

Term Survival ◽

Free Survival ◽

Disease Free

Context Colorectal cancer is the second most prevalent cancer worldwide, and the liver is the most common site of metastases. Surgical resection of colorectal liver metastases provides the sole possibility of cure and the best odds of long-term survival. Objectives To describe surgical outcomes and identify features associated with disease prognosis in patients submitted to synchronous colorectal cancer liver metastasis resection. Methods Retrospective study of 59 patients who underwent surgery for synchronous colorectal cancer liver metastasis. Actuarial survival and disease-free survival were assessed, depending on the prognostic variable of interest. Results Postoperative mortality and morbidity rates were 3.38% and 30.50% respectively. Five-year disease-free survival was estimated at 23.96%, and 5-year overall survival, at 38.45%. Carcinoembryonic antigen levels ≥50 ng/mL and presence of three or more liver metastasis were limiting factors for disease-free survival, but did not affect late survival. No patient with liver metastases and extrahepatic disease had disease-free interval longer than 20 months, but this had no significance or impact on long-term survival. None of the prognostic factors assessed had an impact on late survival, although no patients with more than three liver metastases survived beyond 40 months. Conclusions Although Carcinoembryonic antigen levels and number of metastases are prognostic factors that limit disease-free survival, they had no impact on 5-year survival and, therefore, should not determine exclusion from surgical treatment. Resection is the best treatment option for synchronous colorectal liver metastases, and even for patients with multiple metastases, large tumors and extrahepatic disease, it can provide long-term survival rates over 38%.