Is Simultaneous Resection for Synchronous Colorectal Cancer Liver Metastases Safe and Effective?

Background: Synchronous liver metastases are detected in approximately 20% of all colorectal cancer cases. The most important factor affecting long-term survival is the complete resection of the primary colon tumor and synchronous liver metastasis. At our center, simultaneous resection was adopted as the first surgical option for all patients with synchronous liver metastases who were expected to have R0 resection and over 40% remnant liver parenchyma, regardless of tumor characteristics. In this study, the variables which could cause major complications and affect long-term survival were investigated after the simultaneous resection. Material& Methods: At our center, 832 patients who underwent colorectal cancer resection between January 2010 and January 2018 were examined retrospectively. In 89 of these patients, synchronous liver metastasis was detected. Simultaneous resection was performed in 80 patients who were included in the study. Demographic features, postoperative complications and long-term outcomes were evaluated statistically. Results: Perioperative outcomes, and predictors of postoperative major complications were presented in Table 1. Postoperative major complications occurred in 24 (30%) patients. Early mortality occurred in one patient. Mean overall survival was 59.33 months. The 1-3-5 year overall survival was 89.6%, 63.5% and 41.6%. Mean disease-free survival was 58.98 months. The 1-3-5 year disease-free survival was 79.3%, 51.5% and 51.5%. There was no significant variable found to cause major complication, statistically. Survival was significantly lower in patients had more than 3 metastases (p=0.015), who underwent RF ablation (p=0.023) and the patients with recurrent tumors (p=0.0001). Conclusion: In this study, there was no difference in the short and long term Results when compared with the literature. No significant parameter was found to increase major complication development, but increased number of metastases has a negative effect on survival. It is seen that experienced centers can perform simultaneous resection with similar complication and survival rates regardless of tumor characteristics. Tabled 1Table 1: Perioperative outcomes, and predictors of postoperative major complications.