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Which Strategy Is Better for Resectable Synchronous Liver Metastasis From Colorectal Cancer, Simultaneous Surgery, or Staged Surgery? Multicenter Retrospective Analysis

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Author(s)
Bong-Hyeon KyeSuk-Hwan LeeWoon Kyung JeongChang Sik YuIn Ja ParkHyeong Rok KimJin KimIn Kyu Lee1, Ki-Jea ParkHong-Jo ChoiHo Young KimJeong-Heum BaekYoon-Suk Lee
Keimyung Author(s)
Jeong, Woon Kyung
Department
Dept. of Surgery (외과학)
Journal Title
Annals of surgical treatment and research
Issued Date
2019
Volume
97
Issue
4
Keyword
Colorectal neoplasmsNeoplasm metastasisSurgical oncology
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.
Keimyung Author(s)(Kor)
정운경
Publisher
School of Medicine (의과대학)
Citation
Bong-Hyeon Kye et al. (2019). Which Strategy Is Better for Resectable Synchronous Liver Metastasis From Colorectal Cancer, Simultaneous Surgery, or Staged Surgery? Multicenter Retrospective Analysis. Annals of surgical treatment and research, 97(4), 184–193. doi: 10.4174/astr.2019.97.4.184
Type
Article
ISSN
2288-6796
Source
https://www.astr.or.kr/DOIx.php?id=10.4174/astr.2019.97.4.184
DOI
10.4174/astr.2019.97.4.184
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/42312
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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