Simultaneous resections of colorectal cancer and synchronous liver metastases: A multi-institutional analysis

Srinevas K. Reddy; Timothy M. Pawlik; Daria Zorzi; Ana L. Gleisner; Dario Ribero; Lia Assumpcao; Andrew S. Barbas; Eddie K. Abdalla; Michael A. Choti; Jean Nicolas Vauthey; Kirk A. Ludwig; Christopher R. Mantyh; Michael A. Morse; Bryan M. Clary

doi:10.1245/s10434-007-9522-5

Simultaneous resections of colorectal cancer and synchronous liver metastases: A multi-institutional analysis

Srinevas K. Reddy, Timothy M. Pawlik, Daria Zorzi, Ana L. Gleisner, Dario Ribero, Lia Assumpcao, Andrew S. Barbas, Eddie K. Abdalla, Michael A. Choti, Jean Nicolas Vauthey, Kirk A. Ludwig, Christopher R. Mantyh, Michael A. Morse, Bryan M. Clary

Research output: Contribution to journal › Article › peer-review

350 Scopus citations

Abstract

Background: The safety of simultaneous resections of colorectal cancer and synchronous liver metastases (SCRLM) is not established. This multi-institutional retrospective study compared postoperative outcomes after simultaneous and staged colorectal and hepatic resections. Methods: Clinicopathologic data, treatments, and postoperative outcomes from patients who underwent simultaneous or staged colorectal and hepatic resections at three hepatobiliary centers from 1985-2006 were reviewed. Results: 610 patients underwent simultaneous (n = 135) or staged (n = 475) resections of colorectal cancer and SCRLM. Seventy staged patients underwent colorectal and hepatic resections at the same institution. Simultaneous patients had fewer (median 1 versus 2) and smaller (median 2.5 versus 3.5 cm) metastases and less often underwent major (≥ three segments) hepatectomy (26.7% versus 61.3%, p < 0.05). Combined hospital stay was lower after simultaneous resections (median 8.5 versus 14 days, p < 0.0001). Mortality (1.0% versus 0.5%) and severe morbidity (14.1% versus 12.5%) were similar after simultaneous colorectal resection and minor hepatectomy compared with isolated minor hepatectomy (both p > 0.05). For major hepatectomy, simultaneous colorectal resection increased mortality (8.3% versus 1.4%, p < 0.05) and severe morbidity (36.1% versus 15.1%, p < 0.05). Combined severe morbidity after staged resections was lower compared to simultaneous resections (36.1% versus 17.6%, p = 0.05) for major hepatectomy but similar for minor hepatectomy (14.1% versus 10.5%, p > 0.05). Major hepatectomy independently predicted severe morbidity after simultaneous resections [hazard ratio (HR) = 3.4, p = 0.008]. Conclusions: Simultaneous colorectal and minor hepatic resections are safe and should be performed for most patients with SCRLM. Due to increased risk of severe morbidity, caution should be exercised before performing simultaneous colorectal and major hepatic resections.

Original language	English (US)
Pages (from-to)	3481-3491
Number of pages	11
Journal	Annals of Surgical Oncology
Volume	14
Issue number	12
DOIs	https://doi.org/10.1245/s10434-007-9522-5
State	Published - Dec 2007

Keywords

Chemotherapy
Colorectal cancer
Hepatectomy
Hepatic metastases
Resection
Simultaneous

ASJC Scopus subject areas

Surgery
Oncology

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10.1245/s10434-007-9522-5

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Reddy, S. K., Pawlik, T. M., Zorzi, D., Gleisner, A. L., Ribero, D., Assumpcao, L., Barbas, A. S., Abdalla, E. K., Choti, M. A., Vauthey, J. N., Ludwig, K. A., Mantyh, C. R., Morse, M. A., & Clary, B. M. (2007). Simultaneous resections of colorectal cancer and synchronous liver metastases: A multi-institutional analysis. Annals of Surgical Oncology, 14(12), 3481-3491. https://doi.org/10.1245/s10434-007-9522-5

Reddy, SK, Pawlik, TM, Zorzi, D, Gleisner, AL, Ribero, D, Assumpcao, L, Barbas, AS, Abdalla, EK, Choti, MA, Vauthey, JN, Ludwig, KA, Mantyh, CR, Morse, MA & Clary, BM 2007, 'Simultaneous resections of colorectal cancer and synchronous liver metastases: A multi-institutional analysis', Annals of Surgical Oncology, vol. 14, no. 12, pp. 3481-3491. https://doi.org/10.1245/s10434-007-9522-5

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title = "Simultaneous resections of colorectal cancer and synchronous liver metastases: A multi-institutional analysis",

abstract = "Background: The safety of simultaneous resections of colorectal cancer and synchronous liver metastases (SCRLM) is not established. This multi-institutional retrospective study compared postoperative outcomes after simultaneous and staged colorectal and hepatic resections. Methods: Clinicopathologic data, treatments, and postoperative outcomes from patients who underwent simultaneous or staged colorectal and hepatic resections at three hepatobiliary centers from 1985-2006 were reviewed. Results: 610 patients underwent simultaneous (n = 135) or staged (n = 475) resections of colorectal cancer and SCRLM. Seventy staged patients underwent colorectal and hepatic resections at the same institution. Simultaneous patients had fewer (median 1 versus 2) and smaller (median 2.5 versus 3.5 cm) metastases and less often underwent major (≥ three segments) hepatectomy (26.7% versus 61.3%, p < 0.05). Combined hospital stay was lower after simultaneous resections (median 8.5 versus 14 days, p < 0.0001). Mortality (1.0% versus 0.5%) and severe morbidity (14.1% versus 12.5%) were similar after simultaneous colorectal resection and minor hepatectomy compared with isolated minor hepatectomy (both p > 0.05). For major hepatectomy, simultaneous colorectal resection increased mortality (8.3% versus 1.4%, p < 0.05) and severe morbidity (36.1% versus 15.1%, p < 0.05). Combined severe morbidity after staged resections was lower compared to simultaneous resections (36.1% versus 17.6%, p = 0.05) for major hepatectomy but similar for minor hepatectomy (14.1% versus 10.5%, p > 0.05). Major hepatectomy independently predicted severe morbidity after simultaneous resections [hazard ratio (HR) = 3.4, p = 0.008]. Conclusions: Simultaneous colorectal and minor hepatic resections are safe and should be performed for most patients with SCRLM. Due to increased risk of severe morbidity, caution should be exercised before performing simultaneous colorectal and major hepatic resections.",

keywords = "Chemotherapy, Colorectal cancer, Hepatectomy, Hepatic metastases, Resection, Simultaneous",

author = "Reddy, {Srinevas K.} and Pawlik, {Timothy M.} and Daria Zorzi and Gleisner, {Ana L.} and Dario Ribero and Lia Assumpcao and Barbas, {Andrew S.} and Abdalla, {Eddie K.} and Choti, {Michael A.} and Vauthey, {Jean Nicolas} and Ludwig, {Kirk A.} and Mantyh, {Christopher R.} and Morse, {Michael A.} and Clary, {Bryan M.}",

year = "2007",

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doi = "10.1245/s10434-007-9522-5",

language = "English (US)",

volume = "14",

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T1 - Simultaneous resections of colorectal cancer and synchronous liver metastases

T2 - A multi-institutional analysis

AU - Reddy, Srinevas K.

AU - Pawlik, Timothy M.

AU - Zorzi, Daria

AU - Gleisner, Ana L.

AU - Ribero, Dario

AU - Assumpcao, Lia

AU - Barbas, Andrew S.

AU - Abdalla, Eddie K.

AU - Choti, Michael A.

AU - Vauthey, Jean Nicolas

AU - Ludwig, Kirk A.

AU - Mantyh, Christopher R.

AU - Morse, Michael A.

AU - Clary, Bryan M.

PY - 2007/12

Y1 - 2007/12

N2 - Background: The safety of simultaneous resections of colorectal cancer and synchronous liver metastases (SCRLM) is not established. This multi-institutional retrospective study compared postoperative outcomes after simultaneous and staged colorectal and hepatic resections. Methods: Clinicopathologic data, treatments, and postoperative outcomes from patients who underwent simultaneous or staged colorectal and hepatic resections at three hepatobiliary centers from 1985-2006 were reviewed. Results: 610 patients underwent simultaneous (n = 135) or staged (n = 475) resections of colorectal cancer and SCRLM. Seventy staged patients underwent colorectal and hepatic resections at the same institution. Simultaneous patients had fewer (median 1 versus 2) and smaller (median 2.5 versus 3.5 cm) metastases and less often underwent major (≥ three segments) hepatectomy (26.7% versus 61.3%, p < 0.05). Combined hospital stay was lower after simultaneous resections (median 8.5 versus 14 days, p < 0.0001). Mortality (1.0% versus 0.5%) and severe morbidity (14.1% versus 12.5%) were similar after simultaneous colorectal resection and minor hepatectomy compared with isolated minor hepatectomy (both p > 0.05). For major hepatectomy, simultaneous colorectal resection increased mortality (8.3% versus 1.4%, p < 0.05) and severe morbidity (36.1% versus 15.1%, p < 0.05). Combined severe morbidity after staged resections was lower compared to simultaneous resections (36.1% versus 17.6%, p = 0.05) for major hepatectomy but similar for minor hepatectomy (14.1% versus 10.5%, p > 0.05). Major hepatectomy independently predicted severe morbidity after simultaneous resections [hazard ratio (HR) = 3.4, p = 0.008]. Conclusions: Simultaneous colorectal and minor hepatic resections are safe and should be performed for most patients with SCRLM. Due to increased risk of severe morbidity, caution should be exercised before performing simultaneous colorectal and major hepatic resections.

AB - Background: The safety of simultaneous resections of colorectal cancer and synchronous liver metastases (SCRLM) is not established. This multi-institutional retrospective study compared postoperative outcomes after simultaneous and staged colorectal and hepatic resections. Methods: Clinicopathologic data, treatments, and postoperative outcomes from patients who underwent simultaneous or staged colorectal and hepatic resections at three hepatobiliary centers from 1985-2006 were reviewed. Results: 610 patients underwent simultaneous (n = 135) or staged (n = 475) resections of colorectal cancer and SCRLM. Seventy staged patients underwent colorectal and hepatic resections at the same institution. Simultaneous patients had fewer (median 1 versus 2) and smaller (median 2.5 versus 3.5 cm) metastases and less often underwent major (≥ three segments) hepatectomy (26.7% versus 61.3%, p < 0.05). Combined hospital stay was lower after simultaneous resections (median 8.5 versus 14 days, p < 0.0001). Mortality (1.0% versus 0.5%) and severe morbidity (14.1% versus 12.5%) were similar after simultaneous colorectal resection and minor hepatectomy compared with isolated minor hepatectomy (both p > 0.05). For major hepatectomy, simultaneous colorectal resection increased mortality (8.3% versus 1.4%, p < 0.05) and severe morbidity (36.1% versus 15.1%, p < 0.05). Combined severe morbidity after staged resections was lower compared to simultaneous resections (36.1% versus 17.6%, p = 0.05) for major hepatectomy but similar for minor hepatectomy (14.1% versus 10.5%, p > 0.05). Major hepatectomy independently predicted severe morbidity after simultaneous resections [hazard ratio (HR) = 3.4, p = 0.008]. Conclusions: Simultaneous colorectal and minor hepatic resections are safe and should be performed for most patients with SCRLM. Due to increased risk of severe morbidity, caution should be exercised before performing simultaneous colorectal and major hepatic resections.

KW - Chemotherapy

KW - Colorectal cancer

KW - Hepatectomy

KW - Hepatic metastases

KW - Resection

KW - Simultaneous

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Simultaneous resections of colorectal cancer and synchronous liver metastases: A multi-institutional analysis

Abstract

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