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Erschienen in: European Surgery 5/2014

01.11.2014 | Original Article

Comparison between simultaneous resection and staged resection of synchronous colorectal cancer with resectable liver metastases: a meta-analysis

verfasst von: MS S. M. Bijukchhe, MS L. Heping, PhD, MS Prof. L. Tao

Erschienen in: European Surgery | Ausgabe 5/2014

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Summary

Background

Previously, the surgical management of synchronous colorectal liver metastases has been a staged resection. Now, it is shifting toward the simultaneous resection of colorectal primary and liver metastases. The aim of this study is to compare the outcomes between simultaneous resection and staged resection.

Methods

The studies were identified searching the database including PubMed, Medline, and Cochrane library. The pooled odds ratios (OR) or weighted mean differences (WMD) with 95 % confidence interval (CI) were calculated using either the fixed effect or random effect model.

Results

A total of 20 studies were included with 3194 patients: 1137 to simultaneous resection group and 2057 to staged resection group. The overall survival at 1 year (OR = 0.73, 95 % CI = 0.48–1.11, P = 0.14), 3 year (OR = 1.13, 95 % CI = 0.88–1.44, P = 0.34), and 5 year (OR = 1.08, 95 % CI = 0.84–1.38, P = 0.54) and disease-free survival at 1 year (OR = 0.77, 95 % CI = 0.47–1.2, P = 0.29), 3 year (OR = 0.72, 95 % CI = 0.44–1.18, P = 0.19), and 5 year (OR = 0.60, 95 % CI = 0.34–1.04, P = 0.07) showed no significant difference between the two groups. The operative time (WMD = − 38.61, 95 % CI = − 89.26–12.04, P = 0.14), and postoperative recurrence (OR = 0.86, 95 % CI = 0.58–1.29, P = 0.47) were similar between the two groups. Shorter hospital stay (WMD = 5.49, 95 % CI = − 7.04 to − 3.94, P = 0.00001) and lower overall complication rate (OR = 0.73, 95 % CI = 0.61–0.87, P = 0.0004) were observed in simultaneous resection group.

Conclusion

In appropriately selected patients, simultaneous resection might be considered as the preferred treatment. Simultaneous resection is safe and efficient in the treatment of these patients with the elimination of second major operation.
Literatur
1.
Zurück zum Zitat Ferlay J, Shin H, Bray F, et al. GLOBOCAN 2008, Cancer incidence and mortality worldwide, IARC CancerBase. Lyon: International Agency for Research on Cancer; 2010. Ferlay J, Shin H, Bray F, et al. GLOBOCAN 2008, Cancer incidence and mortality worldwide, IARC CancerBase. Lyon: International Agency for Research on Cancer; 2010.
2.
Zurück zum Zitat Weiss L, Grundmann E, Torhorst J, Hartveit F, Moberg I, Eder M, et al. Haematogenous metastatic patterns in colonic carcinoma: an analysis of 1541 necropsies. J Pathol. 1986;150(3):195–203. PubMedCrossRef Weiss L, Grundmann E, Torhorst J, Hartveit F, Moberg I, Eder M, et al. Haematogenous metastatic patterns in colonic carcinoma: an analysis of 1541 necropsies. J Pathol. 1986;150(3):195–203. PubMedCrossRef
3.
Zurück zum Zitat Scheele J, Altendorf-Hofmann A. Resection of colorectal liver metastases. Langenbeck’s archives of surgery. 1999;384(4):313–27. CrossRef Scheele J, Altendorf-Hofmann A. Resection of colorectal liver metastases. Langenbeck’s archives of surgery. 1999;384(4):313–27. CrossRef
4.
Zurück zum Zitat Scheele J, Stangl R, Altendorf-Hofmann A. Hepatic metastases from colorectal carcinoma: impact of surgical resection on the natural history. Br J Surg. 1990;77(11):1241–6. PubMedCrossRef Scheele J, Stangl R, Altendorf-Hofmann A. Hepatic metastases from colorectal carcinoma: impact of surgical resection on the natural history. Br J Surg. 1990;77(11):1241–6. PubMedCrossRef
5.
Zurück zum Zitat Adam R. Colorectal cancer with synchronous liver metastases. Br J Surg. 2007;94(2):129–31. PubMedCrossRef Adam R. Colorectal cancer with synchronous liver metastases. Br J Surg. 2007;94(2):129–31. PubMedCrossRef
6.
Zurück zum Zitat Nordlinger B, Guiguet M, Vaillant JC, Balladur P, Boudjema K, Bachellier P, et al. Surgical resection of colorectal carcinoma metastases to the liver. A prognostic scoring system to improve case selection, based on 1568 patients. Association Francaise de Chirurgie. Cancer. 1996;77(7):1254–62. PubMedCrossRef Nordlinger B, Guiguet M, Vaillant JC, Balladur P, Boudjema K, Bachellier P, et al. Surgical resection of colorectal carcinoma metastases to the liver. A prognostic scoring system to improve case selection, based on 1568 patients. Association Francaise de Chirurgie. Cancer. 1996;77(7):1254–62. PubMedCrossRef
7.
Zurück zum Zitat Jaeck D, Bachellier P, Weber JC, Mourad M, Walf P, Boudjema K. Surgical treatment of synchronous hepatic metastases of colorectal cancers. Simultaneous or delayed resection? Annales de chirurgie. 1996;50(7):507–12; discussion 13–6. PubMed Jaeck D, Bachellier P, Weber JC, Mourad M, Walf P, Boudjema K. Surgical treatment of synchronous hepatic metastases of colorectal cancers. Simultaneous or delayed resection? Annales de chirurgie. 1996;50(7):507–12; discussion 13–6. PubMed
8.
Zurück zum Zitat Lyass S, Zamir G, Matot I, Goitein D, Eid A, Jurim O. Combined colon and hepatic resection for synchronous colorectal liver metastases. J Surg Oncol. 2001;78(1):17–21. PubMedCrossRef Lyass S, Zamir G, Matot I, Goitein D, Eid A, Jurim O. Combined colon and hepatic resection for synchronous colorectal liver metastases. J Surg Oncol. 2001;78(1):17–21. PubMedCrossRef
9.
Zurück zum Zitat Elias D, Detroz B, Lasser P, Plaud B, Jerbi G. Is simultaneous hepatectomy and intestinal anastomosis safe? Am J Surg. 1995;169(2):254–60. PubMedCrossRef Elias D, Detroz B, Lasser P, Plaud B, Jerbi G. Is simultaneous hepatectomy and intestinal anastomosis safe? Am J Surg. 1995;169(2):254–60. PubMedCrossRef
10.
Zurück zum Zitat de Santibanes E, Lassalle FB, McCormack L, Pekolj J, Quintana GO, Vaccaro C, et al. Simultaneous colorectal and hepatic resections for colorectal cancer: postoperative and longterm outcomes. J Am Coll Surg. 2002;195(2):196–202. PubMedCrossRef de Santibanes E, Lassalle FB, McCormack L, Pekolj J, Quintana GO, Vaccaro C, et al. Simultaneous colorectal and hepatic resections for colorectal cancer: postoperative and longterm outcomes. J Am Coll Surg. 2002;195(2):196–202. PubMedCrossRef
11.
Zurück zum Zitat Martin R, Paty P, Fong Y, Grace A, Cohen A, DeMatteo R, et al. Simultaneous liver and colorectal resections are safe for synchronous colorectal liver metastasis. J Am Coll Surg. 2003;197(2):233–41; discussion 241–2. PubMedCrossRef Martin R, Paty P, Fong Y, Grace A, Cohen A, DeMatteo R, et al. Simultaneous liver and colorectal resections are safe for synchronous colorectal liver metastasis. J Am Coll Surg. 2003;197(2):233–41; discussion 241–2. PubMedCrossRef
12.
Zurück zum Zitat Vassiliou I, Arkadopoulos N, Theodosopoulos T, Fragulidis G, Marinis A, Kondi-Paphiti A, et al. Surgical approaches of resectable synchronous colorectal liver metastases: timing considerations. World J Gastroenterol: WJG. 2007;13(9):1431–4. PubMedCentralPubMedCrossRef Vassiliou I, Arkadopoulos N, Theodosopoulos T, Fragulidis G, Marinis A, Kondi-Paphiti A, et al. Surgical approaches of resectable synchronous colorectal liver metastases: timing considerations. World J Gastroenterol: WJG. 2007;13(9):1431–4. PubMedCentralPubMedCrossRef
13.
Zurück zum Zitat Chua HK, Sondenaa K, Tsiotos GG, Larson DR, Wolff BG, Nagorney DM. Concurrent vs. staged colectomy and hepatectomy for primary colorectal cancer with synchronous hepatic metastases. Dis Colon Rectum. 2004;47(8):1310–6. PubMedCrossRef Chua HK, Sondenaa K, Tsiotos GG, Larson DR, Wolff BG, Nagorney DM. Concurrent vs. staged colectomy and hepatectomy for primary colorectal cancer with synchronous hepatic metastases. Dis Colon Rectum. 2004;47(8):1310–6. PubMedCrossRef
14.
Zurück zum Zitat Jaeck D, Bachellier P, Weber JC, Boudjema K, Mustun A, Paris F, et al. Surgical strategy in the treatment of synchronous hepatic metastases of colorectal cancers. Analysis of a series of 59 operated on patients. Chirurgie. 1999;124(3):258–63. PubMedCrossRef Jaeck D, Bachellier P, Weber JC, Boudjema K, Mustun A, Paris F, et al. Surgical strategy in the treatment of synchronous hepatic metastases of colorectal cancers. Analysis of a series of 59 operated on patients. Chirurgie. 1999;124(3):258–63. PubMedCrossRef
15.
Zurück zum Zitat Weber JC, Bachellier P, Oussoultzoglou E, Jaeck D. Simultaneous resection of colorectal primary tumour and synchronous liver metastases. Br J Surg. 2003;90(8):956–62. PubMedCrossRef Weber JC, Bachellier P, Oussoultzoglou E, Jaeck D. Simultaneous resection of colorectal primary tumour and synchronous liver metastases. Br J Surg. 2003;90(8):956–62. PubMedCrossRef
16.
Zurück zum Zitat Tanaka K, Shimada H, Matsuo K, Nagano Y, Endo I, Sekido H, et al. Outcome after simultaneous colorectal and hepatic resection for colorectal cancer with synchronous metastases. Surgery. 2004;136(3):650–9. PubMedCrossRef Tanaka K, Shimada H, Matsuo K, Nagano Y, Endo I, Sekido H, et al. Outcome after simultaneous colorectal and hepatic resection for colorectal cancer with synchronous metastases. Surgery. 2004;136(3):650–9. PubMedCrossRef
18.
Zurück zum Zitat Brouquet A, Mortenson MM, Vauthey JN, Rodriguez-Bigas MA, Overman MJ, Chang GJ, et al. Surgical strategies for synchronous colorectal liver metastases in 156 consecutive patients: classic, combined or reverse strategy? J Am Coll Surg. 2010;210(6):934–41. PubMedCrossRef Brouquet A, Mortenson MM, Vauthey JN, Rodriguez-Bigas MA, Overman MJ, Chang GJ, et al. Surgical strategies for synchronous colorectal liver metastases in 156 consecutive patients: classic, combined or reverse strategy? J Am Coll Surg. 2010;210(6):934–41. PubMedCrossRef
19.
Zurück zum Zitat Capussotti L, Ferrero A, Vigano L, Ribero D, Lo Tesoriere R, Polastri R. Major liver resections synchronous with colorectal surgery. Ann Surg Oncol. 2007;14(1):195–201. PubMedCrossRef Capussotti L, Ferrero A, Vigano L, Ribero D, Lo Tesoriere R, Polastri R. Major liver resections synchronous with colorectal surgery. Ann Surg Oncol. 2007;14(1):195–201. PubMedCrossRef
20.
Zurück zum Zitat Capussotti L, Vigano’ L, Ferrero A, Lo Tesoriere R, Ribero D, Polastri R. Timing of resection of liver metastases synchronous to colorectal tumor: proposal of prognosis-based decisional model. Ann Surg Oncol. 2007;14(3):1143–50. PubMedCrossRef Capussotti L, Vigano’ L, Ferrero A, Lo Tesoriere R, Ribero D, Polastri R. Timing of resection of liver metastases synchronous to colorectal tumor: proposal of prognosis-based decisional model. Ann Surg Oncol. 2007;14(3):1143–50. PubMedCrossRef
21.
Zurück zum Zitat de Haas RJ, Adam R, Wicherts DA, Azoulay D, Bismuth H, Vibert E, et al. Comparison of simultaneous or delayed liver surgery for limited synchronous colorectal metastases. Br J Surg. 2010;97(8):1279–89. PubMedCrossRef de Haas RJ, Adam R, Wicherts DA, Azoulay D, Bismuth H, Vibert E, et al. Comparison of simultaneous or delayed liver surgery for limited synchronous colorectal metastases. Br J Surg. 2010;97(8):1279–89. PubMedCrossRef
22.
Zurück zum Zitat Kaibori M, Iwamoto S, Ishizaki M, Matsui K, Saito T, Yoshioka K, et al. Timing of resection for synchronous liver metastases from colorectal cancer. Dig Dis Sci. 2010;55(11):3262–70. PubMedCrossRef Kaibori M, Iwamoto S, Ishizaki M, Matsui K, Saito T, Yoshioka K, et al. Timing of resection for synchronous liver metastases from colorectal cancer. Dig Dis Sci. 2010;55(11):3262–70. PubMedCrossRef
23.
Zurück zum Zitat Luo Y, Wang L, Chen C, Chen D, Huang M, Huang Y, et al. Simultaneous liver and colorectal resections are safe for synchronous colorectal liver metastases. J Gastrointest Surg. 2010;14(12):1974–80. PubMedCrossRef Luo Y, Wang L, Chen C, Chen D, Huang M, Huang Y, et al. Simultaneous liver and colorectal resections are safe for synchronous colorectal liver metastases. J Gastrointest Surg. 2010;14(12):1974–80. PubMedCrossRef
24.
Zurück zum Zitat Martin RC 2nd, Augenstein V, Reuter NP, Scoggins CR, McMasters KM. Simultaneous versus staged resection for synchronous colorectal cancer liver metastases. J Am Coll Surg. 2009;208(5):842–50; discussion 850–2. PubMedCrossRef Martin RC 2nd, Augenstein V, Reuter NP, Scoggins CR, McMasters KM. Simultaneous versus staged resection for synchronous colorectal cancer liver metastases. J Am Coll Surg. 2009;208(5):842–50; discussion 850–2. PubMedCrossRef
25.
Zurück zum Zitat Moug SJ, Smith D, Leen E, Roxburgh C, Horgan PG. Evidence for a synchronous operative approach in the treatment of colorectal cancer with hepatic metastases: a case matched study. Eur J Surg Oncol. 2010;36(4):365–70. PubMedCrossRef Moug SJ, Smith D, Leen E, Roxburgh C, Horgan PG. Evidence for a synchronous operative approach in the treatment of colorectal cancer with hepatic metastases: a case matched study. Eur J Surg Oncol. 2010;36(4):365–70. PubMedCrossRef
26.
Zurück zum Zitat van der Pool AE, de Wilt JH, Lalmahomed ZS, Eggermont AM, Ijzermans JN, Verhoef C. Optimizing the outcome of surgery in patients with rectal cancer and synchronous liver metastases. Br J Surg. 2010;97(3):383–90. PubMedCrossRef van der Pool AE, de Wilt JH, Lalmahomed ZS, Eggermont AM, Ijzermans JN, Verhoef C. Optimizing the outcome of surgery in patients with rectal cancer and synchronous liver metastases. Br J Surg. 2010;97(3):383–90. PubMedCrossRef
27.
Zurück zum Zitat Reddy SK, Pawlik TM, Zorzi D, Gleisner AL, Ribero D, Assumpcao L, et al. Simultaneous resections of colorectal cancer and synchronous liver metastases: a multi-institutional analysis. Ann Surg Oncol. 2007;14(12):3481–91. PubMedCrossRef Reddy SK, Pawlik TM, Zorzi D, Gleisner AL, Ribero D, Assumpcao L, et al. Simultaneous resections of colorectal cancer and synchronous liver metastases: a multi-institutional analysis. Ann Surg Oncol. 2007;14(12):3481–91. PubMedCrossRef
28.
Zurück zum Zitat Slupski M, Wlodarczyk Z, Jasinski M, Masztalerz M, Tujakowski J. Outcomes of simultaneous and delayed resections of synchronous colorectal liver metastases. Can J Surg. 2009;52(6):E241–4. PubMedCentralPubMed Slupski M, Wlodarczyk Z, Jasinski M, Masztalerz M, Tujakowski J. Outcomes of simultaneous and delayed resections of synchronous colorectal liver metastases. Can J Surg. 2009;52(6):E241–4. PubMedCentralPubMed
29.
Zurück zum Zitat Thelen A, Jonas S, Benckert C, Spinelli A, Lopez-Hanninen E, Rudolph B, et al. Simultaneous versus staged liver resection of synchronous liver metastases from colorectal cancer. Int J Colorectal Dis. 2007;22(10):1269–76. PubMedCrossRef Thelen A, Jonas S, Benckert C, Spinelli A, Lopez-Hanninen E, Rudolph B, et al. Simultaneous versus staged liver resection of synchronous liver metastases from colorectal cancer. Int J Colorectal Dis. 2007;22(10):1269–76. PubMedCrossRef
30.
Zurück zum Zitat Turrini O, Viret F, Guiramand J, Lelong B, Bege T, Delpero JR. Strategies for the treatment of synchronous liver metastasis. Eur J Surg Oncol. 2007;33(6):735–40. PubMedCrossRef Turrini O, Viret F, Guiramand J, Lelong B, Bege T, Delpero JR. Strategies for the treatment of synchronous liver metastasis. Eur J Surg Oncol. 2007;33(6):735–40. PubMedCrossRef
31.
Zurück zum Zitat Wang QX, Xu B, Yan JJ, Zhou FG, Yan YQ. Treatment strategy for synchronous liver metastasis from colorectal cancer. Ai zheng. 2008;27(7):748–51. PubMed Wang QX, Xu B, Yan JJ, Zhou FG, Yan YQ. Treatment strategy for synchronous liver metastasis from colorectal cancer. Ai zheng. 2008;27(7):748–51. PubMed
32.
Zurück zum Zitat Yan TD, Chu F, Black D, King DW, Morris DL. Synchronous resection of colorectal primary cancer and liver metastases. World J Surg. 2007;31(7):1496–501. PubMedCrossRef Yan TD, Chu F, Black D, King DW, Morris DL. Synchronous resection of colorectal primary cancer and liver metastases. World J Surg. 2007;31(7):1496–501. PubMedCrossRef
33.
Zurück zum Zitat Fong Y, Fortner J, Sun RL, Brennan MF, Blumgart LH. Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases. Ann Surg. 1999;230(3):309–18; discussion 318–21. PubMedCentralPubMedCrossRef Fong Y, Fortner J, Sun RL, Brennan MF, Blumgart LH. Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases. Ann Surg. 1999;230(3):309–18; discussion 318–21. PubMedCentralPubMedCrossRef
34.
Zurück zum Zitat Weber JC, Nakano H, Bachellier P, Oussoultzoglou E, Inoue K, Shimura H, et al. Is a proliferation index of cancer cells a reliable prognostic factor after hepatectomy in patients with colorectal liver metastases? Am J Surg. 2001;182(1):81–8. PubMedCrossRef Weber JC, Nakano H, Bachellier P, Oussoultzoglou E, Inoue K, Shimura H, et al. Is a proliferation index of cancer cells a reliable prognostic factor after hepatectomy in patients with colorectal liver metastases? Am J Surg. 2001;182(1):81–8. PubMedCrossRef
35.
Zurück zum Zitat Weber JC, Schneider A, Rohr S, Nakano H, Bachellier P, Mechine A, et al. Analysis of allelic imbalance in patients with colorectal cancer according to stage and presence of synchronous liver metastases. Ann Surg. 2001;234(6):795–802; discussion 802–3. PubMedCentralPubMedCrossRef Weber JC, Schneider A, Rohr S, Nakano H, Bachellier P, Mechine A, et al. Analysis of allelic imbalance in patients with colorectal cancer according to stage and presence of synchronous liver metastases. Ann Surg. 2001;234(6):795–802; discussion 802–3. PubMedCentralPubMedCrossRef
36.
Zurück zum Zitat Fong Y, Blumgart LH. Hepatic colorectal metastasis: current status of surgical therapy. Oncology (Williston Park). 1998;12(10):1489–98; discussion 1498–500, 1503. Fong Y, Blumgart LH. Hepatic colorectal metastasis: current status of surgical therapy. Oncology (Williston Park). 1998;12(10):1489–98; discussion 1498–500, 1503.
37.
Zurück zum Zitat Vogt P, Raab R, Ringe B, Pichlmayr R. Resection of synchronous liver metastases from colorectal cancer. World J Surg. 1991;15(1):62–7. PubMedCrossRef Vogt P, Raab R, Ringe B, Pichlmayr R. Resection of synchronous liver metastases from colorectal cancer. World J Surg. 1991;15(1):62–7. PubMedCrossRef
38.
Zurück zum Zitat Bolton JS, Fuhrman GM. Survival after resection of multiple bilobar hepatic metastases from colorectal carcinoma. Ann Surg. 2000;231(5):743–51. PubMedCentralPubMedCrossRef Bolton JS, Fuhrman GM. Survival after resection of multiple bilobar hepatic metastases from colorectal carcinoma. Ann Surg. 2000;231(5):743–51. PubMedCentralPubMedCrossRef
39.
Zurück zum Zitat Jenkins LT, Millikan KW, Bines SD, Staren ED, Doolas A. Hepatic resection for metastatic colorectal cancer. Am Surg. 1997;63(7):605–10. PubMed Jenkins LT, Millikan KW, Bines SD, Staren ED, Doolas A. Hepatic resection for metastatic colorectal cancer. Am Surg. 1997;63(7):605–10. PubMed
41.
Zurück zum Zitat Jarnagin WR, Gonen M, Fong Y, DeMatteo RP, Ben-Porat L, Little S, et al. Improvement in perioperative outcome after hepatic resection: analysis of 1,803 consecutive cases over the past decade. Ann Surg. 2002;236(4):397–406; discussion 406–7. PubMedCentralPubMedCrossRef Jarnagin WR, Gonen M, Fong Y, DeMatteo RP, Ben-Porat L, Little S, et al. Improvement in perioperative outcome after hepatic resection: analysis of 1,803 consecutive cases over the past decade. Ann Surg. 2002;236(4):397–406; discussion 406–7. PubMedCentralPubMedCrossRef
Metadaten
Titel
Comparison between simultaneous resection and staged resection of synchronous colorectal cancer with resectable liver metastases: a meta-analysis
verfasst von
MS S. M. Bijukchhe
MS L. Heping
PhD, MS Prof. L. Tao
Publikationsdatum
01.11.2014
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 5/2014
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-014-0286-4