Role of Surgical Approach to Synchronous Colorectal Liver Metastases: A Retrospective Analysis

Abstract

Shengyong Zhai,1,* Xiaojing Sun,2,* Longfeng Du,1 Kai Chen,1 Shanshan Zhang,2 Yiran Shi,1 Fei Yuan1 1Department of Oncology Surgery, Weifang People’ s Hospital, Weifang Medical College, Weifang City, Shandong Province, 261041, People’s Republic of China; 2School of Management and Information, Shandong Transport Vocational College, Weifang City, Shandong Province, 261041, People’s Republic of China*These authors contributed equally to this workCorrespondence: Fei YuanDepartment of Oncology Surgery, Weifang People’s Hospital, Weifang Medical College, NO.181, Guangwen Street, Kuiwen District, Weifang City, Shandong Province, 261041, People’s Republic of ChinaTel [phone]Fax [phone]Email [email protected]: This study is a retrospective analysis of exploring the efficiency of surgical management on patients with synchronous colorectal liver metastasis (SCLM).Patients and Methods: Nine hundred fifty-three consecutive patients with SCLM from Weifang People’s Hospital of Shandong Province between January 2006 and December 2015 were reviewed. The values of different factors were analyzed, such as different surgical indications of liver metastases, simultaneous or staged resection of primary colorectal cancer and liver metastases, and primary tumor resection (PTR) of asymptomatic patients with unresectable liver metastases.Results: Median survival time (47.3 months) and 5-year survival rate (31%) for patients with resected liver metastases were significantly superior to that of with nonoperative treatment (17.2 months, 4%, P< 0.001); enlarging the standard of liver metastases resection can improve the resection rates (31.0% vs 13.6%, P< 0.001); for patients with resectable liver metastases, the in-hospital cost for simultaneous resection group was lower than that in the staged resection group (36,698 vs 45,134 RMB, P< 0.001); for patients of the asymptomatic primary tumor with unresectable liver metastases, PTR was associated with improved median survival (18.0 vs 15.0 months, P=0.006).Conclusion: For patients with SCLM, liver resection is considered the best treatment; expanding indications of liver resection can improve the resection rates. Simultaneous resection of the primary tumor and liver metastases were indicated in patients with resectable SCLM; PTR was recommended for asymptomatic patients with unresectable hepatic metastases.Keywords: surgical treatment, synchronous colorectal liver metastases, survival analysis, primary tumor resection

Keywords

• surgical treatment
• synchronous colorectal liver metastases
• survival analysis
• primary tumor resection.