Liver metastases will develop in more than one-third of patients with colorectal cancer, and among these the liver will be the only site of metastasis in 20%.
The optimal surgical strategy for the treatment of synchronous resectable liver metastasis in patients with colorectal cancer has not previously been defined.
A team of doctors in New York, USA, compared the safety and efficacy of simultaneous and staged resection of the colon and liver.
The research team reviewed 240 patients who had received surgery for primary adenocarcinoma of the large bowel and synchronous hepatic metastasis from 1984 to 2001.
134 patients underwent simultaneous resection of a colorectal tumour and hepatic metastasis in a single operation and 106 patients underwent staged operations.
Complications were less common in the simultaneous resection group, with 49% of patients sustaining complications, compared to 67% of patients who had staged resections.
| By avoiding a second laparotomy, the overall complication rate is reduced, with no change in operative mortality. |
|The Journal of the American College of Surgeons|
Patients who underwent simultaneous resections spent a median 10 days in hospital compared to a median 18 days for patients who underwent 2 separate procedures.
There was no significant difference in mortality between the two surgical options.
The authors of the study conclude. “Given its reduced morbidity, shorter treatment time, and similar cancer outcomes, simultaneous resection should be considered a safe option in patients with resectable synchronous colorectal metastasis.”