Timing of resection of liver metastases synchronous to colorectal tumor:proposal of duration operative time-based decisional model: LTP68

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Aim:Resection of hepatic metastases is thepreferred treatment for patients withprimary colorectal carcinoma, but timing is controversial We select concurrent or staged resection according to thepredicted operative duration. This study was designed to compare outcomes of patients receiving concurrent or staged resection.Method:We retrospectively analyzed 145 consecutive patients (1992-2008) with synchronously recognizedprimary carcinoma and hepatic metastases who underwent concurrent (n = 121) or staged (n = 24) colonic and hepatic resections performed at our institution.Results:Two groups were similar in demographics and characteristics, except the number of hepatic tumor for concurrent resection was smaller than staged resection (mean, 2.1 vs 4.3; P < 0.05). No significant differences were observed between groups in overall duration of hospitalization (mean, 23 days vs 26 days; P = 0.37), perioperative morbidity (53 vs 41%; P = 0.25), 3-year disease-free survival (25 vs 37%; P = 0.21), 3-year overall survival (66 vs 72%; P = 0.78). Overall operative duration (mean, 367 min vs 514 min; P < 0.05) was significantly shorter and overall blood loss (mean 1390 ml vs 3150 ml; P < 0.05) was significantly less for concurrent than for staged resection.Conclusion:Selective strategy concurrent or staged resection for liver metastases from colorectal cancer is safe and efficient.

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