TU2.7 Surgical Management of Synchronous Colorectal Liver Metastases – A Systematic Review and Meta-Analysis

Abstract

Abstract Aims Surgery with curative intent is the mainstay in management of Colorectal cancer, with timing and sequencing of the surgical resection of tumour and the metastases highly important in improving prognosis in patients diagnosed with synchronous Colorectal liver metastases. The current review aims to identify data around simultaneous and staged resection to evaluate if there is a significant difference in either approach. Methods PubMED and EASE's searcher® database were searched, a modified PRISMA checklist used to identify relevant data from the search results and fifteen studies were included in the quantitative analysis, defined by inclusion and exclusion criteria, and scored with the use of MINORS criteria. Meta-analysis is performed with the use of Odds Ratio or Weighted Mean Difference. Results There is significant heterogeneity within the pooled studies potentially due to varied techniques and surgical skills. There was no significant statistical difference in postoperative morbidity, with a slight skew in favor of the staged procedure. There was a statistically significant skew towards a higher mortality in the simultaneous resection group. Intra and Post Operative Complications showed no statistically significant difference in either group. Lack of randomization was observed in underlying studies. Conclusion The analysis does not show a statistically significant difference in outcomes with either intervention. There are distinct methods of thought around which method to employ in various patient scenarios, left to the discretion of the treating specialist. Research suggests further enquiry into use of neoadjuvant and adjuvant chemotherapy to treat the underlying metastases associated with primary tumor.