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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 10/2007

01-10-2007 | Original Article

Simultaneous versus staged liver resection of synchronous liver metastases from colorectal cancer

Authors: Armin Thelen, Sven Jonas, Christoph Benckert, Antonino Spinelli, Enrico Lopez-Hänninen, Birgit Rudolph, Ulf Neumann, Peter Neuhaus

Published in: International Journal of Colorectal Disease | Issue 10/2007

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Abstract

Background and aims

The surgical strategy for treatment of synchronous liver metastases from colorectal cancer remains controversial. This retrospective analysis was conducted to compare the postoperative outcome and survival of patients receiving simultaneous resection of liver metastases and primary colorectal cancer to those receiving staged resection.

Materials and methods

Between January 1988 and September 2005, 219 patients underwent liver resection for synchronous colorectal liver metastases, of whom, 40 patients received simultaneous resection of liver metastases and primary colorectal cancer, and 179 patients staged resections. Patients were identified from a prospective database, and records were retrospectively reviewed. Patient, tumor, and operative parameters were analyzed for their influence on postoperative morbidity and mortality as well as on long-term survival.

Results

Simultaneous liver resections tend to be performed for colon primaries rather than for rectal cancer (p = 0.004) and used less extensive liver resections (p < 0.001). The postoperative morbidity was comparable between both groups, whereas the mortality was significantly higher in patients with simultaneous liver resection (p = 0.012). The mortality after simultaneous liver resection (n = 4) occurred after major hepatectomies, and three of these four patients were 70 years of age or older. There was no significant difference in long-term survival after formally curative simultaneous and staged liver resection.

Conclusion

Simultaneous liver and colorectal resection is as efficient as staged resections in the treatment of patients with colorectal cancer and synchronous liver metastases. To perform simultaneous resections safely a careful patient selection is necessary. The most important criteria to select patients for simultaneous liver resection are age of the patient and extent of liver resection.
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Metadata
Title
Simultaneous versus staged liver resection of synchronous liver metastases from colorectal cancer
Authors
Armin Thelen
Sven Jonas
Christoph Benckert
Antonino Spinelli
Enrico Lopez-Hänninen
Birgit Rudolph
Ulf Neumann
Peter Neuhaus
Publication date
01-10-2007
Publisher
Springer-Verlag
Published in
International Journal of Colorectal Disease / Issue 10/2007
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-007-0286-y

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