Comparative analysis between simultaneous resection and staged resections in patients with synchronous colorectal liver metastases

Abstract

Background: In synchronous colorectal liver metastases (SCLMs), simultaneous resection (SR) has not gained similar acceptance as staged resections (SgR). Methods: This retrospective study compared morbidity, mortality, survival rates and length of hospital stay between patients undergoimg SR vs. SgR. Results: SR was performed in 234 patients, while 66 patients underwent SgR. Comparative morbidity (41% vs. 31.8%, respectively, p = 0.1997), mortality (3.8% vs. 3%, respectively, p = 1) and survival rates (85.3%, 50.8% and 30.1% vs. 86.8%, 49.6% and 22.5%, at 1-, 3- and 5-years, respectively, p = 0.357) were similar between the SR and SgR group. In patients undergoing SR, total hospital stay was significantly shorter than in SgR group (15.11 vs. 19.42 days, respectively, p < 0.0001). Comparative analysis of morbidity, mortality and survival rates between SR and SgR was performed for subgroups of patients presenting following parameters: rectal primary, positive lymph nodes, multiple metastases, bilobar liver metastases, metastases larger than 5 cm, major hepatectomies, preoperative chemotherapy. In each of these subgroups, SR was associated with similar morbidity, mortality and survival rates compared with SgR (p value > 0.05). Conclusion: In patients with SCLMs, SR provides similar short-term and long-term outcomes as SgR, with a shorter hospital stay. In most patients with SCLMs, SR might be considered the treatment of choice.