P-0241 - Surgical management of synchronous colorectal liver metastases: simultaneous versus staged resections

Date 28 June 2014
Event World GI 2014
Session Poster Session
Topics Colon Cancer
Rectal Cancer
Surgery and/or Radiotherapy of Cancer
Presenter Ighor Shchepotin
Citation Annals of Oncology (2014) 25 (suppl_2): ii14-ii104. 10.1093/annonc/mdu165
Authors I. Shchepotin1, A. Lukashenko2, A. Burlaka3, V. Primak1, O. Kolesnik2
  • 1National Cancer Institute, Kyiv/UA
  • 2National Cancer Institute, Kiev/UA
  • 3Bogomolets National Medical University, Kiev/UA

Abstract

Introduction

Surgical treatment of metastatic colorectal cancer remains the only method that improves overall 5-year survival. But the optimal surgical strategy for resectable, synchronous, colorectal liver metastases remains unclear. his study aimed to compare the surgical outcome and survival benefit between synchronous and staged resection of liver metastases from colorectal cancer.

Methods

Clinicopathologic data, treatments, and postoperative outcomes from 110 patients who underwent simultaneous (56 patients, group A) or staged (54 patients, group B) colorectal and hepatic resections at clinic of National cancer institute in period of 2008-2013 were reviewed.

Results

Postoperative complications in patients with simultaneous resections (group A) were observed in 13 cases (23.2%), including 5, 1, 4, 2, 0 and 1 of grades I, II, IIIa, IIIb, IV and V respectively. Similar results have been reported in group B after staged resections, where overall postoperative complications registered in 16 patients (29.6%), including 4, 3, 6, 3, 0 of grades I, II, IIIa, IIIb, IV respectively. Overall level of post-operative complications in the groups A and B after surgical stages finishing did not differ statistically (p = 0.76). Overall 3-year survival in the group of patients with simultaneous resections (group А) was 42.8% and in the group B 51.8% (р = 0.24).

Conclusion

Analysis of our research indicated necessity of the development of differentiated approach in management of synchronous colorectal liver metastatic cancer. Simultaneous resections of colorectal cancer primary lesions and hepatic metastases were safe and could serve as a primary option for selected patients. Subsequent research should be directed towards study of prognosis factors and criteria for patients selection for surgical treatment groups, assessment of economic effect, and patients life quality.