Gerd R Silberhumer1, Philip B Paty2, Larissa K Temple2, Raphael L C Araujo3, Brian Denton4, Mithat Gonen4, Garret M Nash2, Peter J Allen3, Ronald P DeMatteo3, Jose Guillem2, Martin R Weiser2, Michael I D'Angelica3, William R Jarnagin3, Douglas W Wong2, Yuman Fong5. 1. Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Surgery, Medical University Vienna, Vienna, Austria. 2. Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 3. Department of Surgery, Hepatobiliary Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 4. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 5. Department of Surgery, Hepatobiliary Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA. Electronic address: yfong@coh.org.
Abstract
BACKGROUND: One quarter of colorectal cancer patients will present with liver metastasis at the time of diagnosis. Recent studies have shown that simultaneous resections are safe and feasible for stage IV colon cancer. Limited data are available for simultaneous surgery in stage IV rectal cancer patients. METHODS: One hundred ninety-eight patients underwent surgical treatment for stage IV rectal cancer. In 145 (73%) patients, a simultaneous procedure was performed. Fifty-three (27%) patients underwent staged liver resection. A subpopulation of 69 (35%) patients underwent major liver resection (3 segments or more) and 30 (44%) patients with simultaneous surgery. RESULTS: The demographics of the 2 groups were similar. Complication rates were comparable for simultaneous or staged resections, even in the group subjected to major liver resection. Total hospital stay was significantly shorter for the simultaneously resected patients (P < .01). CONCLUSIONS: Simultaneous resection of rectal primaries and liver metastases is a safe procedure in carefully selected patients at high-volume institutions, even if major liver resections are required.
BACKGROUND: One quarter of colorectal cancerpatients will present with liver metastasis at the time of diagnosis. Recent studies have shown that simultaneous resections are safe and feasible for stage IV colon cancer. Limited data are available for simultaneous surgery in stage IV rectal cancerpatients. METHODS: One hundred ninety-eight patients underwent surgical treatment for stage IV rectal cancer. In 145 (73%) patients, a simultaneous procedure was performed. Fifty-three (27%) patients underwent staged liver resection. A subpopulation of 69 (35%) patients underwent major liver resection (3 segments or more) and 30 (44%) patients with simultaneous surgery. RESULTS: The demographics of the 2 groups were similar. Complication rates were comparable for simultaneous or staged resections, even in the group subjected to major liver resection. Total hospital stay was significantly shorter for the simultaneously resected patients (P < .01). CONCLUSIONS: Simultaneous resection of rectal primaries and liver metastases is a safe procedure in carefully selected patients at high-volume institutions, even if major liver resections are required.
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