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Trends and outcomes of simultaneous versus staged resection of synchronous colorectal cancer and colorectal liver metastases.

Publication ,  Journal Article
Tsilimigras, DI; Sahara, K; Hyer, JM; Diaz, A; Moris, D; Bagante, F; Guglielmi, A; Ruzzenente, A; Alexandrescu, S; Poultsides, G; Sasaki, K ...
Published in: Surgery
July 2021

The objective of this study was to assess trends in the use as well as the outcomes of patients undergoing simultaneous versus staged resection for synchronous colorectal liver metastases.Patients undergoing resection for colorectal liver metastases between 2008 and 2018 were identified using a multi-institutional database. Trends in use and outcomes of simultaneous resection of colorectal liver metastases were examined over time and compared with that of staged resection after propensity score matching.Among 1,116 patients undergoing resection for colorectal liver metastases, 690 (61.8%) patients had synchronous disease. Among them, 314 (45.5%) patients underwent simultaneous resection, while 376 (54.5%) had staged resection. The proportion of patients undergoing simultaneous resection for synchronous colorectal liver metastases increased over time (2008: 37.2% vs 2018: 47.4%; ptrend = 0.02). After propensity score matching (n = 201 per group), patients undergoing simultaneous resection for synchronous colorectal liver metastases had a higher incidence of overall (44.8% vs 34.3%; P = .03) and severe complications (Clavien-Dindo ≥III) (16.9% vs 7.0%; P = .002) yet comparable 90-day mortality (3.5% vs 1.0%; P = .09) compared with patients undergoing staged resection. The incidence of severe morbidity decreased over time (2008: 50% vs 2018: 11.1%; ptrend = 0.02). Survival was comparable among patients undergoing simultaneous versus staged resection of colorectal liver metastases (3-year overall survival: 66.1% vs 62.3%; P = .67). Following simultaneous resection, severe morbidity and mortality increased incrementally based on the extent of liver resection and complexity of colectomy.While simultaneous resection was associated with increased morbidity, the incidence of severe morbidity decreased over time. Long-term survival was comparable after simultaneous resection versus staged resection of colorectal liver metastases.

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Published In

Surgery

DOI

EISSN

1532-7361

ISSN

0039-6060

Publication Date

July 2021

Volume

170

Issue

1

Start / End Page

160 / 166

Related Subject Headings

  • Surgery
  • Propensity Score
  • Postoperative Complications
  • Middle Aged
  • Male
  • Liver Neoplasms
  • Kaplan-Meier Estimate
  • Humans
  • Hepatectomy
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
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Tsilimigras, D. I., Sahara, K., Hyer, J. M., Diaz, A., Moris, D., Bagante, F., … Pawlik, T. M. (2021). Trends and outcomes of simultaneous versus staged resection of synchronous colorectal cancer and colorectal liver metastases. Surgery, 170(1), 160–166. https://doi.org/10.1016/j.surg.2021.01.041
Tsilimigras, Diamantis I., Kota Sahara, J Madison Hyer, Adrian Diaz, Dimitrios Moris, Fabio Bagante, Alfredo Guglielmi, et al. “Trends and outcomes of simultaneous versus staged resection of synchronous colorectal cancer and colorectal liver metastases.Surgery 170, no. 1 (July 2021): 160–66. https://doi.org/10.1016/j.surg.2021.01.041.
Tsilimigras DI, Sahara K, Hyer JM, Diaz A, Moris D, Bagante F, et al. Trends and outcomes of simultaneous versus staged resection of synchronous colorectal cancer and colorectal liver metastases. Surgery. 2021 Jul;170(1):160–6.
Tsilimigras, Diamantis I., et al. “Trends and outcomes of simultaneous versus staged resection of synchronous colorectal cancer and colorectal liver metastases.Surgery, vol. 170, no. 1, July 2021, pp. 160–66. Epmc, doi:10.1016/j.surg.2021.01.041.
Tsilimigras DI, Sahara K, Hyer JM, Diaz A, Moris D, Bagante F, Guglielmi A, Ruzzenente A, Alexandrescu S, Poultsides G, Sasaki K, Aucejo F, Ejaz A, Cloyd JM, Pawlik TM. Trends and outcomes of simultaneous versus staged resection of synchronous colorectal cancer and colorectal liver metastases. Surgery. 2021 Jul;170(1):160–166.
Journal cover image

Published In

Surgery

DOI

EISSN

1532-7361

ISSN

0039-6060

Publication Date

July 2021

Volume

170

Issue

1

Start / End Page

160 / 166

Related Subject Headings

  • Surgery
  • Propensity Score
  • Postoperative Complications
  • Middle Aged
  • Male
  • Liver Neoplasms
  • Kaplan-Meier Estimate
  • Humans
  • Hepatectomy
  • Female