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Techniques in Coloproctology

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01-02-2013 | Review

The management of rectal cancer with synchronous liver metastases: a modern surgical dilemma

Authors: A. A. P. Slesser, A. Bhangu, G. Brown, S. Mudan, P. P. Tekkis

Published in: Techniques in Coloproctology | Issue 1/2013

Abstract

Introduction

One in ten patients with rectal cancer presents with synchronous colorectal liver metastases. We present an up-to-date review of the different surgical strategies available for rectal cancer patients with synchronous colorectal liver metastases.

Method

A literature review of MEDLINE, Cochrane and Google scholar was performed.

Results

Twenty retrospective studies comparing staged versus simultaneous resections were found. Overall survival was similar for both approaches whilst the length of stay was decreased in simultaneous resections. Only two studies comparing the ‘reverse’ versus staged or simultaneous resections were found. The studies investigating resection versus non-resection for rectal primaries with unresectable liver metastases were limited.

Conclusion

Simultaneous resections are a reasonable alternative to staged resections for either advanced rectal cancers with limited liver disease or early rectal cancers with extensive liver disease. Currently, staged resections are favoured over simultaneous resections in patients with locally advanced rectal cancers with extensive liver disease. There are too few studies to determine the safety of reverse resections in the context of locally advanced rectal cancers. A resection of the primary tumour or a non-surgical intervention can be justified in the management of the rectal cancer primary in the presence of unresectable liver metastases.

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Title: The management of rectal cancer with synchronous liver metastases: a modern surgical dilemma
Authors: A. A. P. Slesser
A. Bhangu
G. Brown
S. Mudan
P. P. Tekkis
Publication date: 01-02-2013
Publisher: Springer Milan
Published in: Techniques in Coloproctology / Issue 1/2013
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI: https://doi.org/10.1007/s10151-012-0888-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The management of rectal cancer with synchronous liver metastases: a modern surgical dilemma

Abstract

Introduction

Method

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Method

Results

Conclusion

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