Simultaneous and two-stage approaches in patients with colorectal cancer and synchronous liver metastasis

Abstract

The aim of the work: to analyze simultaneous and two-stage approaches in the treatment of patients with colorectal cancer and synchronous liver metastasis, as well as their overall and disease-free survival.

Materials and Methods. 16 patients (10 men and 6 women) patients with colorectal cancer and synchronous liver metastasis who underwent simultaneous (14) and two-stage (2) radical resections at Ternopil University Hospital from 2013 to 2018. All colorectal resections were performed in accordance with the requirements of oncological radicalism (D3 lymphodissection, total mesocolic/mesorectal excision). In 9 patients, liver metastasis were localized in the left lobe and in 7 patients – in the right lobe. Parenchymal-sparing technique for liver resection was used in 13 (81.3 %) patients, while anatomic resection of the liver was performed in 3 (18.8 %) patients. Adjuvant chemptherapy was given to all patients (6 courses of FOLFOX or XELOX).

Results and Discussion. We did not observe any severe postoperative complication or 30-day mortality. The median overall and disease-free survival in the group of patients with regional metastasis was (24.3±4.8) (p <0.013) and 13 months (p <0.020) respectively (all patients died between 4 and 44 months). All patients who had no regional lymph nodes metastasis are still alive without signs of progression. The longest overall survival period is 80 months and are observed at the time of writing of this article in 3 patients (follow-up period 11–80 months). The median overall and disease-free survival in the patients with right-sided CRC was 17.3 (p <0.51) and 9.2 months (p <0.51), respectively. Simultaneous CRC resection and parenchymal-sparing liver resection do not show an increase in the number of severe postoperative complications and 30-day mortality, which is also confirmed by our study.