Colorectal cancer, liver metastases can be resected simultaneously

Last Updated: 2016-04-20

By David Douglas

NEW YORK (Reuters Health) - In the substantial fraction of colorectal cancer patients with liver metastasis, simultaneous resection seems an appropriate approach, according to U.S. and Austrian researchers.

As Dr. Yuman Fong told Reuters Health by email, "Recent technical and medical advances now allow safe combined resections of primary colorectal cancer and the accompanying liver metastases with potential curative intent."

In a paper online April 11 in Surgery, Dr. Fong of the City of Hope in Duarte, California, and colleagues note that about 25% of patients have simultaneous diagnoses. The standard approach calls for liver resection weeks to months after resection of the primary colorectal tumor.

Although there is evidence of success, they point out that "combined procedures for patients requiring major liver resection for tumor clearance are still not recommended universally and are an issue of debate."

To compare outcomes, the team examined data covering 1984 to 2004 on 320 patients who had simultaneous resection and a further 109 who had staged resection.

The mean size of the hepatic metastases was significantly greater in the staged group (4 cm vs. 2.5 cm), but there was no difference in the distribution of primary tumor locations.

One-year survival was 90.5% in the simultaneous group and 92.6% in the staged group. Five-year survival was 38.5% and 38.9%. Disease-free survival was also comparable, the researchers say.

With simultaneous resection, said Dr. Fong, "The result for the patient is a faster recovery and more rapid transition to effective adjuvant chemotherapy."

"The most important implication," he concluded, "is that presentation of liver metastases simultaneous with diagnosis of a colorectal primary cancer, which was once thought to be a terminal situation, can now potentially be cured by a single operation."

SOURCE: http://bit.ly/1U6CsXC

Surgery 2016.