Synchronous resection of primary colorectal tumor, liver metastases safe in some patients

the ONA take:

A recent study examined and compared patient outcomes associated with synchronous and sequential colorectal and liver resections in patients with stage IV colorectal cancer.

Generally, a combination therapy involving chemotherapy and surgical resection is used to treat colorectal cancer, but debate remains as to whether metastatic tumors should be surgically removed at the same time as the primary tumors (synchronously), as opposed to a sequential approach.

Researchers from the Mayo Clinic, led by David Nagorney, M.D., used a multi-institutional database to review a pool of 43,408 patients who underwent colorectal and liver resections for stage IV colorectal cancer. Individuals in the pool were assigned risk categories based on the extent of resection, as well as colorectal resection location. 

The investigators compared outcomes within each category, comparing those that underwent synchronous colorectal and liver resections vs those who had these operations performed sequentially. The study goal was to evaluate the risk of the component operations and determine which combination of colon and liver procedures  was safest.

Study data indicate that poor patient outcomes are tied more closely to the risk of individual procedures as opposed to timing. major complications are linked to the extent of resection required (liver resection or colorectal surgery).

The study data also indicate that synchronous resection of primary colorectal tumors and metastatic liver tumors is safe when minor liver resections are required.

Study results were published in Journal of Gastrointestinal Surgery.

Synchronous resection of primary colorectal tumor, liver metastases safe in some patients
Patient outcomes associated with synchronous and sequential colorectal and liver resections in patients with stage IV colorectal cancer.
About 20 percent of colorectal cancer patients have cancers that have spread (metastasized) beyond the colon at the time of their diagnosis. The liver is the most common site for these metastases. The approach to treating primary tumors within the colon and metastatic tumors in the liver continues to evolve; however, it typically involves chemotherapy plus surgical removal (resection) of both types of tumors.
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