Which strategy is better for resectable synchronous liver metastasis from colorectal cancer, simultaneous surgery, or staged surgery? Multicenter retrospective analysis
10.4174/astr.2019.97.4.184
- Author:
Bong Hyeon KYE
1
;
Suk Hwan LEE
;
Woon Kyung JEONG
;
Chang Sik YU
;
In Ja PARK
;
Hyeong Rok KIM
;
Jin KIM
;
In Kyu LEE
;
Ki Jea PARK
;
Hong Jo CHOI
;
Ho Young KIM
;
Jeong Heum BAEK
;
Yoon Suk LEE
Author Information
1. Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea. yslee@catholic.ac.kr
- Publication Type:Multicenter Study
- Keywords:
Colorectal neoplasms;
Neoplasm metastasis;
Surgical oncology
- MeSH:
Classification;
Colorectal Neoplasms;
Drug Therapy;
Follow-Up Studies;
Hepatectomy;
Hospitals, University;
Humans;
Korea;
Liver;
Neoplasm Metastasis;
Rectal Neoplasms;
Retrospective Studies
- From:Annals of Surgical Treatment and Research
2019;97(4):184-193
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The optimal treatment for synchronous liver metastasis (LM) from colorectal cancer (CRC) depends on various factors. The present study was intended to investigate the oncologic outcome according to the time of resection of metastatic lesions. METHODS: Data from patients who underwent treatment with curative intent for primary CRC and synchronous LM between 2004 and 2009 from 9 university hospitals in Korea were collected retrospectively. One hundred forty-three patients underwent simultaneous resection for primary CRC and synchronous LM (simultaneous surgery group), and 65 patients were treated by 2-stage operation (staged surgery group). RESULTS: The mean follow-up length was 41.2 ± 24.6 months. In the extent of resection for hepatic metastasis, major hepatectomy was more frequently performed in staged surgery group (33.8% vs. 8.4%, P < 0.001). The rate of severe complications of Clavien-Dindo classification grade III or more was not significantly different between the 2 groups. The 3-year overall survival (OS) rate was 85.0% in staged surgery group and 69.4% in simultaneous surgery group (P = 0.013), and the 3-year recurrence-free survival (RFS) rate was 46.4% in staged surgery group and 30.2% in simultaneous surgery group (P = 0.143). In subgroup analysis based on the location of primary CRC, the benefit of staged surgery for OS and RFS was clearly shown in rectal cancer (P = 0.021 and P = 0.015). CONCLUSION: Based on our results, staged surgery with or without neoadjuvant chemotherapy should be considered for resectable synchronous LM from CRC, especially in rectal cancer, as a safe and fairly promising option.
