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. 2015 Jun;209(6):935-42.
doi: 10.1016/j.amjsurg.2014.09.024. Epub 2014 Dec 13.

Simultaneous resection for rectal cancer with synchronous liver metastasis is a safe procedure

Gerd R Silberhumer  1 , Philip B Paty  2 , Larissa K Temple  2 , Raphael L C Araujo  3 , Brian Denton  4 , Mithat Gonen  4 , Garret M Nash  2 , Peter J Allen  3 , Ronald P DeMatteo  3 , Jose Guillem  2 , Martin R Weiser  2 , Michael I D'Angelica  3 , William R Jarnagin  3 , Douglas W Wong  2 , Yuman Fong  5
Affiliations

Simultaneous resection for rectal cancer with synchronous liver metastasis is a safe procedure

Gerd R Silberhumer et al. Am J Surg. 2015 Jun.

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.

Keywords: Complications; Simultaneous resection; Stage IV rectal cancer.

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Figures

Figure 1
Figure 1
Changes in practice over time. The use of staged or simultaneous (Simult) resections for patients is shown.
See this image and copyright information in PMC

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