Comparison of Sequential, Delayed and Simultaneous Resection Strategies for Synchronous Colorectal Liver Metastases
Background: The present study aimed to compare the perioperative safety and long-term survival of patients with synchronous colorectal liver metastases undergoing sequential resection (SeR), delayed resection (DeR) and simultaneous resection (SiR). Methods: From January 2007 to December 2016, data from patients undergoing surgery at Peking University Cancer Hospital for synchronous colorectal liver metastases were retrospectively collected. The above three different surgical strategies were compared. Results: A total of 233 cases were included, with 49 in the SeR group, 98 in the DeR group and 86 in the SiR group. The incidence of severe complications was 26.7% in the SiR group, higher than that in the DeR group (11.2%, P = 0.007) and the SeR group (16.3%, P =0.166). The overall survival at 1 and 3 years in the SeR group (93.9% and 50.1%) was lower than that in the DeR group (94.9% and 64.8%, P = 0.019), but not significantly different from that in the SiR group (93.0% and 55.2%, P = 0.378). Recurrence-free survival at 1 and 3 years in the SeR group (22.4% and 18.4%) was lower than that in the DeR group (43.9% and 24.2%, P = 0.033) but not significantly different from that in the SiR group (31.4% and 19.6%, P = 0.275). Cox multivariate analysis indicated that T4, lymph node-positive primary tumour, liver metastases >30 mm and SiR (compared with DeR) were correlated with poor prognosis. Conclusion: Simultaneous resection has a relatively higher incidence of severe complications, and with a staged resection strategy, the prognosis of delayed resection was better than that of sequential resection.
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Invitations sent on 04 Sep, 2019
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Comparison of Sequential, Delayed and Simultaneous Resection Strategies for Synchronous Colorectal Liver Metastases
On 17 Jan, 2020
On 10 Jan, 2020
On 09 Jan, 2020
Posted 06 Jan, 2020
On 06 Jan, 2020
On 30 Dec, 2019
On 29 Dec, 2019
On 29 Dec, 2019
On 17 Dec, 2019
Received 14 Dec, 2019
Received 05 Dec, 2019
On 29 Nov, 2019
On 24 Nov, 2019
Invitations sent on 19 Nov, 2019
On 28 Oct, 2019
On 27 Oct, 2019
On 27 Oct, 2019
On 29 Sep, 2019
Received 22 Sep, 2019
Received 20 Sep, 2019
Received 19 Sep, 2019
Received 19 Sep, 2019
Received 19 Sep, 2019
On 06 Sep, 2019
On 05 Sep, 2019
On 05 Sep, 2019
On 05 Sep, 2019
On 05 Sep, 2019
On 05 Sep, 2019
On 04 Sep, 2019
Invitations sent on 04 Sep, 2019
On 04 Sep, 2019
On 04 Sep, 2019
On 02 Sep, 2019
On 02 Sep, 2019
On 24 Aug, 2019
Background: The present study aimed to compare the perioperative safety and long-term survival of patients with synchronous colorectal liver metastases undergoing sequential resection (SeR), delayed resection (DeR) and simultaneous resection (SiR). Methods: From January 2007 to December 2016, data from patients undergoing surgery at Peking University Cancer Hospital for synchronous colorectal liver metastases were retrospectively collected. The above three different surgical strategies were compared. Results: A total of 233 cases were included, with 49 in the SeR group, 98 in the DeR group and 86 in the SiR group. The incidence of severe complications was 26.7% in the SiR group, higher than that in the DeR group (11.2%, P = 0.007) and the SeR group (16.3%, P =0.166). The overall survival at 1 and 3 years in the SeR group (93.9% and 50.1%) was lower than that in the DeR group (94.9% and 64.8%, P = 0.019), but not significantly different from that in the SiR group (93.0% and 55.2%, P = 0.378). Recurrence-free survival at 1 and 3 years in the SeR group (22.4% and 18.4%) was lower than that in the DeR group (43.9% and 24.2%, P = 0.033) but not significantly different from that in the SiR group (31.4% and 19.6%, P = 0.275). Cox multivariate analysis indicated that T4, lymph node-positive primary tumour, liver metastases >30 mm and SiR (compared with DeR) were correlated with poor prognosis. Conclusion: Simultaneous resection has a relatively higher incidence of severe complications, and with a staged resection strategy, the prognosis of delayed resection was better than that of sequential resection.
Figure 1
Figure 2