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Research article
Comparison of Sequential, Delayed and Simultaneous Resection Strategies for Synchronous Colorectal Liver Metastases
Bao-Cai Xing
Corresponding Author
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This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Surgery.
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.
Keywords
Colorectal cancer, liver metastases, liver resection, prognosis
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CURRENT STATUS: Published
Published
On 17 Jan, 2020
No community comments so far
Submission checks complete
On 10 Jan, 2020
Editorial decision: Accept
On 09 Jan, 2020
Version 3
Posted 06 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 06 Jan, 2020
Editor assigned
On 30 Dec, 2019
Submission checks complete
On 29 Dec, 2019
Editor invited
On 29 Dec, 2019
No comments provided
Editorial decision: Minor revision
On 17 Dec, 2019
Review #2 received
Received 14 Dec, 2019
Review #1 received
Received 05 Dec, 2019
Reviewer #2 agreed
On 29 Nov, 2019
Reviewer #1 agreed
On 24 Nov, 2019
Reviewers invited
Invitations sent on 19 Nov, 2019
Editor assigned
On 28 Oct, 2019
Submission checks complete
On 27 Oct, 2019
Editor invited
On 27 Oct, 2019
No comments provided
Editorial decision: Major revision
On 29 Sep, 2019
Review #1 received
Received 22 Sep, 2019
Review #5 received
Received 20 Sep, 2019
Review #3 received
Received 19 Sep, 2019
Review #4 received
Received 19 Sep, 2019
Review #2 received
Received 19 Sep, 2019
Reviewer #8 agreed
On 06 Sep, 2019
Reviewer #5 agreed
On 05 Sep, 2019
Reviewer #6 agreed
On 05 Sep, 2019
Reviewer #7 agreed
On 05 Sep, 2019
Reviewer #3 agreed
On 05 Sep, 2019
Reviewer #4 agreed
On 05 Sep, 2019
Editor assigned
On 04 Sep, 2019
Reviewers invited
Invitations sent on 04 Sep, 2019
Reviewer #1 agreed
On 04 Sep, 2019
Reviewer #2 agreed
On 04 Sep, 2019
Submission checks complete
On 02 Sep, 2019
Editor invited
On 02 Sep, 2019
First submitted
On 24 Aug, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
General Surgery
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This preprint is under consideration at BMC Surgery. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Comparison of Sequential, Delayed and Simultaneous Resection Strategies for Synchronous Colorectal Liver Metastases
Bao-Cai Xing
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Published
On 17 Jan, 2020
No community comments so far
Submission checks complete
On 10 Jan, 2020
Editorial decision: Accept
On 09 Jan, 2020
Version 3
Posted 06 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 06 Jan, 2020
Editor assigned
On 30 Dec, 2019
Submission checks complete
On 29 Dec, 2019
Editor invited
On 29 Dec, 2019
No comments provided
Editorial decision: Minor revision
On 17 Dec, 2019
Review #2 received
Received 14 Dec, 2019
Review #1 received
Received 05 Dec, 2019
Reviewer #2 agreed
On 29 Nov, 2019
Reviewer #1 agreed
On 24 Nov, 2019
Reviewers invited
Invitations sent on 19 Nov, 2019
Editor assigned
On 28 Oct, 2019
Submission checks complete
On 27 Oct, 2019
Editor invited
On 27 Oct, 2019
No comments provided
Editorial decision: Major revision
On 29 Sep, 2019
Review #1 received
Received 22 Sep, 2019
Review #5 received
Received 20 Sep, 2019
Review #3 received
Received 19 Sep, 2019
Review #4 received
Received 19 Sep, 2019
Review #2 received
Received 19 Sep, 2019
Reviewer #8 agreed
On 06 Sep, 2019
Reviewer #5 agreed
On 05 Sep, 2019
Reviewer #6 agreed
On 05 Sep, 2019
Reviewer #7 agreed
On 05 Sep, 2019
Reviewer #3 agreed
On 05 Sep, 2019
Reviewer #4 agreed
On 05 Sep, 2019
Editor assigned
On 04 Sep, 2019
Reviewers invited
Invitations sent on 04 Sep, 2019
Reviewer #1 agreed
On 04 Sep, 2019
Reviewer #2 agreed
On 04 Sep, 2019
Submission checks complete
On 02 Sep, 2019
Editor invited
On 02 Sep, 2019
First submitted
On 24 Aug, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
General Surgery
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Surgery.
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