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Simultaneous resection of colorectal cancer and synchronous liver metastases: what determines the risk of unfavorable outcomes? An international multicenter retrospective cohort study

Title: Simultaneous resection of colorectal cancer and synchronous liver metastases: what determines the risk of unfavorable outcomes? An international multicenter retrospective cohort study
Authors: Sijberden J. P.; Zimmitti G.; Conci S.; Russolillo N.; Masetti M.; Cipriani F.; Lanari J.; Gorgec B.; Benedetti Cacciaguerra A.; Rotellar F.; D'Hondt M.; Edwin B.; Sutcliffe R. P.; Dagher I.; Efanov M.; Lopez-Ben S.; Primrose J. N.; Giuliante F.; Spinelli A.; Chand M.; Alvarez S.; Langella S.; Nicosia S.; Ruzzenente A.; Vivarelli M.; Cillo U.; Aldrighetti L.; Jovine E.; Ferrero A.; Guglielmi A.; Besselink M. G.; Abu Hilal M.
Contributors: Sijberden, J. P.; Zimmitti, G.; Conci, S.; Russolillo, N.; Masetti, M.; Cipriani, F.; Lanari, J.; Gorgec, B.; Benedetti Cacciaguerra, A.; Rotellar, F.; D'Hondt, M.; Edwin, B.; Sutcliffe, R. P.; Dagher, I.; Efanov, M.; Lopez-Ben, S.; Primrose, J. N.; Giuliante, F.; Spinelli, A.; Chand, M.; Alvarez, S.; Langella, S.; Nicosia, S.; Ruzzenente, A.; Vivarelli, M.; Cillo, U.; Aldrighetti, L.; Jovine, E.; Ferrero, A.; Guglielmi, A.; Besselink, M. G.; Abu Hilal, M.
Publisher Information: NLM (Medline)
Publication Year: 2023
Description: BACKGROUND: The use of a simultaneous resection (SIMR) in patients with synchronous colorectal liver metastases (sCRLM) has increased over the past decades. However, it remains unclear when a SIMR is beneficial and when it should be avoided. The aim of this retrospective cohort study was therefore to compare the outcomes of a SIMR for sCRLM in different settings, and to assess which factors are independently associated with unfavorable outcomes. METHODS: To perform this retrospective cohort study, patients with sCRLM undergoing SIMR (2004-2019) were extracted from an international multicenter database, and their outcomes were compared after stratification according to the type of liver and colorectal resection performed. Factors associated with unfavorable outcomes were identified through multivariable logistic regression. RESULTS: Overall, 766 patients were included, encompassing colorectal resections combined with a major liver resection (n=122), minor liver resection in the anterolateral (n=407), or posterosuperior segments ('Technically major', n=237). Minor and technically major resections, compared to major resections, were more often combined with a rectal resection (29.2 and 36.7 vs. 20.5%, respectively, both P=0.003) and performed fully laparoscopic (22.9 and 23.2 vs. 6.6%, respectively, both P = 0.003). Major and technically major resections, compared to minor resections, were more often associated with intraoperative transfusions (42.9 and 38.8 vs. 20%, respectively, both P = 0.003) and unfavorable incidents (9.6 and 9.8 vs. 3.3%, respectively, both P≤0.063). Major resections were associated, compared to minor and technically major resections, with a higher overall morbidity rate (64.8 vs. 50.4 and 49.4%, respectively, both P≤0.024) and a longer length of stay (12 vs. 10 days, both P≤0.042). American Society of Anesthesiologists grades ≥3 [adjusted odds ratio (aOR): 1.671, P=0.015] and undergoing a major liver resection (aOR: 1.788, P=0.047) were independently associated with an increased risk of ...
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/37093069; info:eu-repo/semantics/altIdentifier/wos/WOS:000996182800006; volume:109; issue:3; firstpage:244; lastpage:254; numberofpages:11; journal:INTERNATIONAL JOURNAL OF SURGERY; https://hdl.handle.net/20.500.11768/163459
DOI: 10.1097/JS9.0000000000000068
Availability: https://hdl.handle.net/20.500.11768/163459; https://doi.org/10.1097/JS9.0000000000000068; https://journals.lww.com/international-journal-of-surgery/fulltext/2023/03000/simultaneous_resection_of_colorectal_cancer_and.9.aspx
Rights: info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by-nc-nd/4.0/
Accession Number: edsbas.A5FDA242
Database: BASE