Combined Proctectomy and Hepatectomy for Metastatic Rectal Cancer: Safe for the Fit and Able—But for Everyone?

Excerpt

This month’s issue of Annals of Surgical Oncology features a publication by Concors et al. illustrating contemporary variability in outcomes for patients undergoing combined hepatectomy and proctectomy (C-PH) for rectal cancer.1 Importantly, this study provides increasing evidence that C-PH at high-volume centers is safe and can be primarily utilized for patients with synchronous hepatic metastasis from rectal cancer; these data are critical for patient counseling and surgical decision making. Furthermore, the authors are able to identify a subset of patients, particularly those who are older and more frail, in whom C-PH should be approached with extreme caution. This clinically relevant, multi-institutional investigation capitalizes on the strengths of the National Cancer Data Base (NCDB) in reporting real-world utilization and outcomes in the US. …