Efficacy and safety of simultaneous resection versus staged resection for initially resectable rectal cancer with synchronous liver metastases
10.12025/j.issn.1008-6358.2025.20250227
- VernacularTitle:初始可切除同时性直肠癌肝转移同步切除与分期切除的疗效与安全性评估
- Author:
Zhekun HUANG
1
;
Yang LÜ
2
;
Songbin LIN
1
;
Jianmin XU
2
;
Wentao TANG
2
Author Information
1. Department of General Surgery, Zhongshan Hospital (Xiamen Branch), Fudan University, Xiamen 361015, Fujian, China.
2. Department of Colorectal Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
- Publication Type:Originalarticle
- Keywords:
initially resectable rectal cancer with liver metastases;
simultaneous resection;
staged resection
- From:
Chinese Journal of Clinical Medicine
2025;32(3):355-361
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the safety and efficacy of simultaneous resection for initially resectable rectal cancer with synchronous liver metastases. Methods A retrospective analysis was conducted on 305 patients with initially resectable rectal cancer with synchronous liver metastases. These patients were diagnosed at Zhongshan Hospital, Fudan University from January 2016 to June 2020. Among them, 191 underwent simultaneous rectum and liver resection and 114 underwent staged resection. Propensity score matching (PSM) was performed at a 1∶1 ratio. Clinical data were compared and Kaplan-Meier survival curves were plotted. Results After PSM, 85 patients were included in each group. General data showed no significant differences. Except for liver metastasis resection method, no statistical differences were found in primary tumor surgery approach, intraoperative blood loss, intraoperative complications, time to first flatus and defecation, 30-day mortality, and postoperative hospital stay between the simultaneous resection group and the staged resection group. The overall complication rate was higher in the simultaneous resection group (48.2% vs 29.4%, P＝0.04). Specifically, the grade Ⅱ complications were significantly higher (29.4% vs 14.1%, P＝0.016), but there’s no differences in severe complications (grade Ⅲ-Ⅴ). No statistically differences were observed in median progression-free survival (HR＝0.70, 95%CI 0.50-0.97, P＝0.103) and 5-year overall survival (HR＝0.95, 95%CI 0.63-1.44, P＝0.259). Conclusions Simultaneous resection demonstrates comparable safety and efficacy to staged resection for initially resectable rectal cancer with synchronous liver metastases.
