Abstract
This study compared postoperative outcomes and survival rates of patients who underwent simultaneous or staged resection for synchronous colorectal cancer liver metastases. Between 2005 and 2018, 126 patients were registered prospectively at a university hospital in Sweden, 63 patients who underwent simultaneous resection were matched against 63 patients who underwent staged resection. The length of hospital stay was shorter for the simultaneous resection group, at 11 vs 16 days, p= <0.001. Fewer patients experienced recurrence in the simultaneous resection group 39 vs 50 patients, p=0.012. There were no significant differences in disease-free survival and overall survival between the groups. Age (hazard ratio [HR] 1.72; 95% CI 1.01-2.94; p=0.049) and Clavien-Dindo score (HR 2.22; 95% CI 1.06-4.67; p=0.035) had impact on survival. Colorectal cancer with synchronous liver metastases can be resected simultaneously, and enables a shorter treatment time without jeopardizing oncological outcomes.
Highlights
Colorectal cancer (CRC) is the third most common type of cancer in the Western world and the fourth most common cause of cancer death worldwide.[1]
All patients resected for colorectal liver metastasis at a university hospital in the southern part of Sweden were prospectively registered in a local database as well as in the Swedish national liver registry (SweLiv) and in the Swedish colorectal cancer
A higher proportion of patients in the simultaneous resection group tended to have a primary tumour located in the rectum 24 (38%) vs 14 (22%), p = 0.052
Summary
Colorectal cancer (CRC) is the third most common type of cancer in the Western world and the fourth most common cause of cancer death worldwide.[1]. The oncological treatment available has evolved from mainly 5-fluorouracil (5-FU)-based regimens, which have limited effects, to a wide variety of chemotherapeutic agents and monoclonal antibodies, which have been shown to be more effective.[2] Synchronous colorectal cancer and liver metastasis is an especially complex situation with a high tumour burden that has traditionally been regarded and treated as two distinct diseases. This study compared postoperative outcomes and survival rates of patients who underwent simultaneous or staged resection for synchronous colorectal cancer liver metastases. Results: The length of hospital stay was shorter for the simultaneous resection group, at 11 vs 16 days, p =
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