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Published in: World Journal of Surgery 9/2010

01-09-2010

Short-Term and Long-Term Outcomes After Simultaneous Resection of Colorectal Malignancies and Synchronous Liver Metastases

Authors: Eduardo de Santibañes, Diego Fernandez, Carlos Vaccaro, Guillermo Ojea Quintana, Fernando Bonadeo, Juan Pekolj, Carlos Bonofiglio, Ernesto Molmenti

Published in: World Journal of Surgery | Issue 9/2010

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Abstract

Background

We evaluated the simultaneous resection of colorectal malignancies and synchronous liver metastases.

Methods

Between June 1982 and June 2006, a total of 752 patients underwent resection of colorectal hepatic metastases. In all, 185 (25%) of them underwent simultaneous resection of the hepatic lesions and the corresponding primary tumors.

Results

The median hospital stay was 8 days (range 4–24 days), with a median operating time of 4 h (range 2–8 h). Altogether, 62 (33.5%) patients required intraoperative transfusion of packed red blood cells (median 2.1 IU, range 1–5 IU), and 25 (13.5%) were given frozen fresh plasma (median 2.1 IU, range 1–4 IU). The morbidity rate was 20.5%. There were two postoperative deaths (mortality rate 1.08%) within 30 days of the surgical intervention. Major hepatectomy was associated with greater morbidity (37.2% vs. 16.2%, P < 0.01) and mortality (4.7% vs. 0%, P < 0.05) rates. For the overall survivals (OS) at 3 and 5 years were 60.1% (52.3–67.85%) and 36.1% (27.4-44.8%), respectively. Disease-free survivals (DFS) at 3 and 5 years were 37.7% (30.2–45.3%) and 26.5% (18.7–34.3%), respectively. Transfusion of blood products, CEA level ≥ 200 ng/dl, and N2 node status were found to be prognostic factors by univariate analysis. CEA level ≥ 200 ng/dl and N2 node status achieved prognostic significance by multivariate analysis.

Conclusions

The simultaneous resection of colorectal malignancies and synchronous liver metastases is safe, avoids an additional intervention, can be performed with low morbidity and mortality, and is associated with good oncologic outcomes. Node stage N2 and CEA level ≥ 200 ng/dl should be given special consideration when selecting patients.
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Metadata
Title
Short-Term and Long-Term Outcomes After Simultaneous Resection of Colorectal Malignancies and Synchronous Liver Metastases
Authors
Eduardo de Santibañes
Diego Fernandez
Carlos Vaccaro
Guillermo Ojea Quintana
Fernando Bonadeo
Juan Pekolj
Carlos Bonofiglio
Ernesto Molmenti
Publication date
01-09-2010
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 9/2010
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-010-0654-6

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