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Published in: Journal of Gastrointestinal Surgery 12/2015

01-12-2015 | Original Article

Minimally Invasive Resection of Colorectal Cancer Liver Metastases Leads to an Earlier Initiation of Chemotherapy Compared to Open Surgery

Authors: Samer Tohme, Julie Goswami, Katrina Han, Alexis P. Chidi, David A. Geller, Srinevas Reddy, Ana Gleisner, Allan Tsung

Published in: Journal of Gastrointestinal Surgery | Issue 12/2015

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Abstract

Introduction

Previous studies have shown benefit not only from postoperative chemotherapy but also from a short interval to initiation of treatment after resection of primary colorectal cancer. The aim of this study was to determine difference in timing to postoperative chemotherapy for minimally invasive resection (MIR) vs. open resection (OR) of colorectal cancer liver metastases (CRCLM).

Methods

This is a retrospective review of 1:1 matched patients undergoing MIR (n = 66) and OR (n = 66) for CRCLM at a single institution.

Results

Patients undergoing MIR of CRCLM had significantly shorter length of hospital stay, fewer major complications, and shorter interval to postoperative chemotherapy (median 42 vs. 63 days, p < 0.001). Univariable analysis showed that surgical approach, postoperative complications, blood loss, number of lesions, and length of stay were associated with timing to chemotherapy. On multivariable analysis, surgical approach was still associated with timing to chemotherapy, and postoperative complications resulted in a delay of chemotherapy among patients who underwent OR but not among those who underwent MIR. In addition, worse disease-free survival was seen among patients who received postoperative chemotherapy more than 60 days after surgery.

Conclusion

By modifying the deleterious effects of postoperative complications on timing of postoperative chemotherapy, patients undergoing MIR for CRCLM are treated with chemotherapy sooner after surgery compared to those undergoing OR.
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Metadata
Title
Minimally Invasive Resection of Colorectal Cancer Liver Metastases Leads to an Earlier Initiation of Chemotherapy Compared to Open Surgery
Authors
Samer Tohme
Julie Goswami
Katrina Han
Alexis P. Chidi
David A. Geller
Srinevas Reddy
Ana Gleisner
Allan Tsung
Publication date
01-12-2015
Publisher
Springer US
Published in
Journal of Gastrointestinal Surgery / Issue 12/2015
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-015-2962-5

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