Simultaneous Resection for Synchronous Colorectal Liver Metastasis: the New Standard of Care?

Overview

Journal J Gastrointest Surg

Specialty Gastroenterology

Date 2017 Apr 16

PMID 28411351

Citations 19

Authors

Jonathan S Abelson

Fabrizio Michelassi

Tianyi Sun

Jialin Mao

Jeffrey Milsom

Benjamin Samstein

Art Sedrakyan

Heather L Yeo

Affiliations

Soon will be listed here.

Abstract

Background: Optimal surgical management for patients with synchronous colorectal cancer liver metastasis is controversial. We provide an analysis of surgical utilization and outcomes for patients presenting with synchronous colon and rectal cancer liver metastasis between simultaneous and staged approaches.

Methods: SPARCS database was used to follow patients undergoing surgery for colorectal cancer with liver metastases from 2005 to 2014. Using International Classification of Diseases, Ninth Revision codes, we identified patients undergoing staged and simultaneous resection. Our primary endpoint was major events at 30-day follow-up.

Results: Of the patients, 1430 underwent surgery for synchronous colorectal primary and liver metastases between 2005 and 2014. There was no difference in adjusted rates of major events or anastomotic leak. Patients undergoing simultaneous resection were significantly less likely to experience prolonged length of stay (OR = 0.28; 95% CI = 0.21-0.37) or high hospital charges (OR = 0.24; 95% CI = 0.17-0.32) compared to staged resection even among patients undergoing total hepatic lobectomy and complex colorectal resection.

Conclusions: Simultaneous resection was found to be equally as safe as staged resection even when evaluating patients undergoing more complex operations, and led to lower health care utilization. Under appropriate clinical circumstances, simultaneous resection offers benefits to patients and the health care system and should be the recommended surgical approach.

Citing Articles

Surgical and Interventional Management of Liver Metastasis.

Itenberg E, Lozano A Clin Colon Rectal Surg. 2024; 37(2):80-84.

PMID: 38322597 PMC: 10843883. DOI: 10.1055/s-0042-1758822.

Pushing the Limits of Surgical Resection in Colorectal Liver Metastasis: How Far Can We Go?.

Calderon Novoa F, Ardiles V, De Santibanes E, Pekolj J, Goransky J, Mazza O Cancers (Basel). 2023; 15(7).

PMID: 37046774 PMC: 10093442. DOI: 10.3390/cancers15072113.

Griffiths C, Karanicolas P, Gallinger S, Wei A, Francescutti V, Serrano P Ann Surg Oncol. 2022; 30(3):1331-1338.

PMID: 36350458 PMC: 11005481. DOI: 10.1245/s10434-022-12696-6.

Oncological outcomes of neoadjuvant chemotherapy in patients with resectable synchronous colorectal liver metastasis: A result from a propensity score matching study.

Jiang Y, Zhou S, Chen J, Liang J Front Oncol. 2022; 12:951540.

PMID: 36330479 PMC: 9623041. DOI: 10.3389/fonc.2022.951540.

Outcomes of simultaneous resection for elderly patients with colorectal liver metastasis: A propensity score matching analysis.

Chen Q, Zhang Y, Deng Y, Huang Z, Zhao H, Cai J Cancer Med. 2022; 11(24):4913-4926.

PMID: 35608250 PMC: 9761077. DOI: 10.1002/cam4.4826.

References

Martin R, Paty P, Fong Y, Grace A, Cohen A, DeMatteo R . Simultaneous liver and colorectal resections are safe for synchronous colorectal liver metastasis. J Am Coll Surg. 2003; 197(2):233-41; discussion 241-2. DOI: 10.1016/S1072-7515(03)00390-9. View

Lyass S, Zamir G, Matot I, Goitein D, Eid A, Jurim O . Combined colon and hepatic resection for synchronous colorectal liver metastases. J Surg Oncol. 2001; 78(1):17-21. DOI: 10.1002/jso.1117. View

Silberhumer G, Paty P, Temple L, Araujo R, Denton B, Gonen M . Simultaneous resection for rectal cancer with synchronous liver metastasis is a safe procedure. Am J Surg. 2015; 209(6):935-42. PMC: 4603659. DOI: 10.1016/j.amjsurg.2014.09.024. View

Mayo S, Pulitano C, Marques H, Lamelas J, Wolfgang C, de Saussure W . Surgical management of patients with synchronous colorectal liver metastasis: a multicenter international analysis. J Am Coll Surg. 2013; 216(4):707-16. PMC: 3994665. DOI: 10.1016/j.jamcollsurg.2012.12.029. View

Muangkaew P, Cho J, Han H, Yoon Y, Choi Y, Jang J . Outcomes of Simultaneous Major Liver Resection and Colorectal Surgery for Colorectal Liver Metastases. J Gastrointest Surg. 2015; 20(3):554-63. DOI: 10.1007/s11605-015-2979-9. View

Makela J, Haukipuro K, Laitinen S, Kairaluoma M . Palliative operations for colorectal cancer. Dis Colon Rectum. 1990; 33(10):846-50. DOI: 10.1007/BF02051920. View

Thelen A, Jonas S, Benckert C, Spinelli A, Lopez-Hanninen E, Rudolph B . Simultaneous versus staged liver resection of synchronous liver metastases from colorectal cancer. Int J Colorectal Dis. 2007; 22(10):1269-76. DOI: 10.1007/s00384-007-0286-y. View

Martin 2nd R, Augenstein V, Reuter N, Scoggins C, McMasters K . Simultaneous versus staged resection for synchronous colorectal cancer liver metastases. J Am Coll Surg. 2009; 208(5):842-50. DOI: 10.1016/j.jamcollsurg.2009.01.031. View

Lambert L, Colacchio T, Barth Jr R . Interval hepatic resection of colorectal metastases improves patient selection. Arch Surg. 2000; 135(4):473-9; discussion 479-80. DOI: 10.1001/archsurg.135.4.473. View

10.

Manfredi S, Lepage C, Hatem C, Coatmeur O, Faivre J, Bouvier A . Epidemiology and management of liver metastases from colorectal cancer. Ann Surg. 2006; 244(2):254-9. PMC: 1602156. DOI: 10.1097/01.sla.0000217629.94941.cf. View

11.

Ruo L, Gougoutas C, Paty P, Guillem J, Cohen A, Wong W . Elective bowel resection for incurable stage IV colorectal cancer: prognostic variables for asymptomatic patients. J Am Coll Surg. 2003; 196(5):722-8. DOI: 10.1016/S1072-7515(03)00136-4. View

12.

Elixhauser A, Steiner C, Harris D, Coffey R . Comorbidity measures for use with administrative data. Med Care. 1998; 36(1):8-27. DOI: 10.1097/00005650-199801000-00004. View

13.

Hamed O, Bhayani N, Ortenzi G, Kaifi J, Kimchi E, Staveley-OCarroll K . Simultaneous colorectal and hepatic procedures for colorectal cancer result in increased morbidity but equivalent mortality compared with colorectal or hepatic procedures alone: outcomes from the National Surgical Quality Improvement Program. HPB (Oxford). 2013; 15(9):695-702. PMC: 3948537. DOI: 10.1111/hpb.12031. View

14.

de Haas R, Adam R, Wicherts D, Azoulay D, Bismuth H, Vibert E . Comparison of simultaneous or delayed liver surgery for limited synchronous colorectal metastases. Br J Surg. 2010; 97(8):1279-89. DOI: 10.1002/bjs.7106. View

15.

Jarnagin W, Gonen M, Fong Y, DeMatteo R, Ben-Porat L, Little S . Improvement in perioperative outcome after hepatic resection: analysis of 1,803 consecutive cases over the past decade. Ann Surg. 2002; 236(4):397-406; discussion 406-7. PMC: 1422593. DOI: 10.1097/01.SLA.0000029003.66466.B3. View

16.

JENKINS L, Millikan K, Bines S, Staren E, Doolas A . Hepatic resection for metastatic colorectal cancer. Am Surg. 1997; 63(7):605-10. View

17.

Leporrier J, Maurel J, Chiche L, Bara S, Segol P, Launoy G . A population-based study of the incidence, management and prognosis of hepatic metastases from colorectal cancer. Br J Surg. 2006; 93(4):465-74. DOI: 10.1002/bjs.5278. View

18.

De Santibanes E, Fernandez D, Vaccaro C, Quintana G, Bonadeo F, Pekolj J . Short-term and long-term outcomes after simultaneous resection of colorectal malignancies and synchronous liver metastases. World J Surg. 2010; 34(9):2133-40. DOI: 10.1007/s00268-010-0654-6. View

19.

Abbott A, Parsons H, Tuttle T, Jensen E . Short-term outcomes after combined colon and liver resection for synchronous colon cancer liver metastases: a population study. Ann Surg Oncol. 2012; 20(1):139-47. DOI: 10.1245/s10434-012-2515-z. View

20.

Vogt P, Raab R, Ringe B, Pichlmayr R . Resection of synchronous liver metastases from colorectal cancer. World J Surg. 1991; 15(1):62-7. DOI: 10.1007/BF01658964. View