832 Analysis of Surgical Outcomes and Survival Benefit of Simultaneous Resection of the Primary Colonic Tumour and Liver Metastasis – Experience of a UK Tertiary Centre Between 2013-2022

Abstract

Abstract Introduction 22% of patients with colorectal cancer present with synchronous metastases. Traditionally, surgical management for these patients is performed separately although increasingly these are being done as simultaneous resections as supported by NICE, UK. Large-scale data to support this is limited and heterogeneous. Aim We aimed to analyse the experience of simultaneous resection at a UK tertiary centre with attention to surgical, oncological outcomes, and survival benefits. Method A prospective database between 2013-2022 was analysed, and clinical data were collared. Statistics performed using R. Results Ninety-six simultaneous resections were reviewed. 71% were left-sided including rectal and 29% were right-sided, while 69% and 31% of patients underwent minor and major liver resections respectively. The majority of cases were performed as open (77%), laparoscopic (16%), or converted to open (6.5%). 30-day mortality was 1% and morbidity rate was 55.4% (Clavien Dindo III 39.2%, IV 4%). Stoma formation rate was 34%. To date, 62% had recurrent disease, 55% received further chemotherapy and 29% had further resections. Median time to recurrence was 31.2 weeks. Median total survival was 34 months. Left-sided and minor liver resections tended towards improved survival, but this was non-significant; survival was significantly improved for those patients diagnosed via the bowel cancer screening program (BSCP). Conclusions Simultaneous resection of colorectal cancer and liver metastases is safe with low mortality and an acceptable morbidity rate. Overall survival of 34 months is promising with further analysis required into oncological strategies and improving uptake of the BSCP.