Simultaneous vs. staged resection for synchronous colorectal liver metastases: a metaanalysis

Chen, Jinggui; Li, Qingguo; Wang, Changjian; Zhu, Huiyan; Shi, Yingqiang; Zhao, Guijuan

doi:10.1007/s00384-010-1018-2

Cited by 87 publications

(89 citation statements)

References 34 publications

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“…This has been shown consistently in the literature 7,9,12,20,22,[24][25][26] and in our study. Even in studies where morbidity was significantly higher in Simultaneous resection n = 100 CRC cases with liver resection and the simultaneous group, the overall length of stay in this group was still shorter.…”

Section: Discussionsupporting

confidence: 93%

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Simultaneous resection of primary colorectal cancer and synchronous liver metastases: a population-based study

Nanji

Mackillop

Wei

et al. 2017

CJS

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Background: Simultaneous resection of primary colorectal cancer (CRC) and syn chron ous liver metastases (LM) is gaining interest. We describe management and out comes of patients undergoing simultaneous resection in the general population. Methods: All patients with CRC who underwent surgical resection of LM between 2002 and 2009 were identified using the populationbased Ontario Cancer Registry and linked electronic treatment records. Synchronous disease was defined as having resection of CRCLM within 12 weeks of surgery for the primary tumour. Results: During the study period, 1310 patients underwent resection of CRCLM. Of these, 226 (17%) patients had synchronous disease; 100 (44%) had a simultaneous resection and 126 (56%) had a staged resection. For the simultaneous and the staged groups, the mean number of liver lesions resected was 1.6 and 2.3, respectively (p < 0.001); the mean size of the largest lesion was 3.1 and 4.8 cm, respectively (p < 0.001); and the major hepatic resection rate was 21% and 79%, respectively (p < 0.001). Post operative mortality for simultaneous cases at 90 days was less than 5%. Fiveyear overall survival and cancerspecific survival for patients with simultaneous resection was 36% (95% confidence interval [CI] 26%-45%) and 37% (95% CI 25%-50%), respectively. Simultaneous resections are common in the general population. A more conservative approach is being adopted for simultaneous resections by limiting the extent of liver resection. Postoperative mortality and longterm survival in this patient population is similar to that reported in other contemporary series. Conclusion: Compared with a staged approach, patients undergoing simultaneous resections had fewer and smaller liver metastases and underwent less aggressive resec tions. Onethird of these patients achieved longterm survival.

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Section: Discussionsupporting

confidence: 93%

“…5,6,8,12,20,21,25,26,28 In these series, 5year OS for simultaneous resections ranged from 29% to 55%; our results suggest that com parable outcomes are achieved in routine practice. We report outcomes of patients who underwent staged resections for illustrative purposes only.…”

Section: Discussionmentioning

confidence: 52%

Simultaneous resection of primary colorectal cancer and synchronous liver metastases: a population-based study

Nanji

Mackillop

Wei

et al. 2017

CJS

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“…Chen et al [27] performed a meta-analysis on 14 studies that retrospectively compared concomitant resection to staged resection in patients with resectable synchronous hepatic metastases. The analysis was performed on a total of 2204 patients of whom 1384 (ages 56-64.9 yrs) had received simultaneous resection and 817 (ages 58-61 yrs) staged resection.…”

Section: Timing Of Surgical Resection Of Primary Tumour and Synchronomentioning

confidence: 99%

“…The level of evidence for OS and postoperative morbidity in case of simultaneous vs. staged resection of the primary tumour and hepatic metastases was downgraded to moderate (Table 10). It is therefore plausible that there is no difference in OS after simultaneous resection compared to staged resection of the primary tumour and resectable synchronous liver metastases [27] but that concomitant resection of the primary tumour and synchronous liver metastases results in lower postoperative morbidity compared to staged resection [3,27].…”

Section: Conclusion Based On Grade Profilesmentioning

confidence: 99%

Pooled analysis of the surgical treatment for colorectal cancer liver metastases

Veereman

Robays

Verleye

et al. 2015

Critical Reviews in Oncology/Hematology

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“…Because simultaneous major hepatectomy was associated with severe morbidity rate (36.1% vs. 17.6%) and mortality (8.3% vs. 1.4%) [13], a staged operation for synchronous and multiple hepatic nodules has been recommended with a delay of at least 3 months after the primary resection. In contrast, based on the results of simultaneous resection to have similar operative times, intraoperative blood loss, and complications [11], recent studies showed simultaneous resection to enhance safety [3,14,15]. According to the safety concepts for such surgical procedures, simultaneous colorectal and liver resections have been evaluated as grade C under the recommended guidelines [16], however, no randomized trials have been published.…”

Section: The Role Of Surgical Proceduresmentioning

confidence: 99%

Strategies for Synchronous and Multiple Metastatic Liver Tumors Designed from Epithelial-Mesenchymal Transition Concept

Osada¹,

Imai²,

Sasaki³

et al. 2012

JCT

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At some point in the natural course of colorectal cancer up to 50% of patients will develop metastasis to the liver and it is one of the most critical effects for patient prognosis. The incidence of synchronous liver metastasis has been detected at around 20% -25%, but the optimal timing of surgical resection remains controversial. Neoadjuvant chemotherapy has also been found to be beneficial not only for initially unresectable but also resectable synchronous metastases. Then, traditional surgical strategies of hepatic resection in accordance with past chemotherapeutic regimens have been used decreasingly over the past several years. This review will primarily discuss treatments in association with the recent developed chemotherapeutic regimens and surgical procedure from the clinical data and the concept for epithetlial-mesenchymal transition, which has recently been studied to elucidate mechanisms of the liver metastatic process.

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Simultaneous vs. staged resection for synchronous colorectal liver metastases: a metaanalysis

Cited by 87 publications

References 34 publications

Simultaneous resection of primary colorectal cancer and synchronous liver metastases: a population-based study

Simultaneous resection of primary colorectal cancer and synchronous liver metastases: a population-based study

Pooled analysis of the surgical treatment for colorectal cancer liver metastases

Strategies for Synchronous and Multiple Metastatic Liver Tumors Designed from Epithelial-Mesenchymal Transition Concept

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