Trends and Outcomes of Synchronous Resection of Colorectal Metastasis in the Modern Era—Analysis of Targeted Hepatic NSQIP Database

Jones, Tashzna; Murphy, Amy E.; Tameron, Ashley; Hussain, Lala R.; Grannan, Kevin; Guend, Hamza; Dunki-Jacobs, Erik M.; Lee, David Y.

doi:10.1016/j.jss.2019.01.021

Cited by 18 publications

(11 citation statements)

References 29 publications

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“…The negative effect from synchronous diagnosis of primary colorectal tumour and CRLM is possibly a result of patients in this group who underwent simultaneous resection of both the colorectal primary tumour and CRLM in one surgical session. Earlier studies have shown a negative effect on postoperative outcomes of this treatment regime [33,34]. Not included in the case-mix model was a minimally invasive approach.…”

Section: Table 2bmentioning

confidence: 99%

Case-mix adjustment to compare nationwide hospital performances after resection of colorectal liver metastases

Elfrink

Zwet²,

Swijnenburg

et al. 2021

European Journal of Surgical Oncology

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Background: Differences in patient demographics and disease burden can influence comparison of hospital performances. This study aimed to provide a case-mix model to compare short-term postoperative outcomes for patients undergoing liver resection for colorectal liver metastases (CRLM). Methods: This retrospective, population-based study included all patients who underwent liver resection for CRLM between 2014 and 2018 in the Netherlands. Variation in case-mix variables between hospitals and influence on postoperative outcomes was assessed using multivariable logistic regression. Primary outcomes were 30-day major morbidity and 30-day mortality. Validation of results was performed on the data from 2019. Results: In total, 4639 patients were included in 28 hospitals. Major morbidity was 6.2% and mortality was 1.4%. Uncorrected major morbidity ranged from 3.3% to 13.7% and mortality ranged from 0.0% to 5.0%. between hospitals. Significant differences between hospitals were observed for age higher than 80

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Section: Table 2bmentioning

confidence: 99%

Case-mix adjustment to compare nationwide hospital performances after resection of colorectal liver metastases

Elfrink

Zwet²,

Swijnenburg

et al. 2021

European Journal of Surgical Oncology

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“…In Japan, it is estimated that pedicle clamping is performed routinely in 25% of segmentectomies, in 9% of lobectomies, and in 34% depending on the indication [59]. A recent American national database analysis reported that American surgeons perform pedicle clamping in more than 25% of cases [60]. In Europe, this maneuver is used routinely by 20% of surgeons, and by 71% of them depending on the surgical indication [61].…”

Section: Discussionmentioning

confidence: 99%

Shorter Survival after Liver Pedicle Clamping in Patients Undergoing Liver Resection for Hepatocellular Carcinoma Revealed by a Systematic Review and Meta-Analysis

Wassmer

Moeckli

Berney

et al. 2021

Cancers

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Liver pedicle clamping minimizes surgical bleeding during hepatectomy. However, by inducing ischemia-reperfusion injury to the remnant liver, pedicle clamping may be associated with tumor recurrence in the regenerating liver. Hepatocellular carcinoma (HCC) having a high rate of recurrence, evidences demonstrating an eventual association with pedicle clamping is strongly needed. We did a systematic review of the literature until April 2020, looking at studies reporting the impact of liver pedicle clamping on long-term outcomes in patients undergoing liver resection for HCC. Primary and secondary outcomes were overall survival (OS) and disease-free survival, respectively. Results were obtained by random-effect meta-analysis and expressed as standardized mean difference (SMD). Eleven studies were included, accounting for 8087 patients. Results of seven studies were pooled in a meta-analysis. Findings indicated that, as compared to control patients who did not receive liver pedicle clamping, those who did had a significantly shorter OS (SMD = −0.172, 95%CI: −0.298 to −0.047, p = 0.007, I2 = 76.8%) and higher tumor recurrence rates (odds ratio 1.36 1.01 to 1.83. p = 0.044, I2 = 50.7%). This meta-analysis suggests that liver pedicle clamping may have a deleterious impact on long-term outcomes. An individual patient-data meta-analysis of randomized trials evaluating liver pedicle clamping is urgently needed.

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“…Speci cally for rectal cancer, recently some authors proposed an "interval strategy", consisting in long-course radio-chemotherapy (RT/CT), followed shortly after completion by resection of liver metastases and 6 to 8 weeks after the end of RT, rectal surgery [10]. Another possibility is the simultaneous CRC + SLM resection with promising results in well-selected patients with few co-morbidities and little extensive liver damage (mainly minor hepatectomies) [11,12,13,14,15,16,17]. Numerous retrospective studies have compared the simultaneous or staged strategies.…”

Section: Introductionmentioning

confidence: 99%

Simultaneous or Staged Resection for Synchronous Liver Metastasis and Primary Rectal Cancer: A Propensity Score Matching Analysis

Karam

Bucur

Gil

et al. 2022

Preprint

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Background:Colorectal cancer is the third most common cancer in France and by the time of the diagnosis, 15 to 25% of patients will suffer from synchronous liver metastases. Surgery associated to neoadjuvant treatment can cure these patients, but few studies focus only on rectal cancer. This study was meant to compare the outcomes of patients who underwent a simultaneous resection to those who underwent a staged resection (rectum first or liver first) in the University Hospital of Tours, France.Methods:We assessed retrospectively a prospective maintained data base about the clinical, pathological and survival outcomes of patients who underwent a simultaneous or a staged resection in our center between 2010 and 2018. A propensity score matching was used, considering the initial characteristics of our groups.Results:There were 70 patients (55/15 males, female respectively) with median age 60 (54-68) years. After matching 48 (69%) of them underwent a staged approach and 22 (31%) a simultaneous approach were compared. No differences were found in terms of morbidity (p = 0.210), overall survival (p = 0.517) and disease-free survival (p = 0.691) at 3 years after matching. There were significantly less recurrences in the simultaneous group (50% vs 81.8%, p = 0.026) Conclusions:Simultaneous resection of the rectal primary cancer and synchronous liver metastases is safe and feasible with no difference in terms of survival.

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Trends and Outcomes of Synchronous Resection of Colorectal Metastasis in the Modern Era—Analysis of Targeted Hepatic NSQIP Database

Cited by 18 publications

References 29 publications

Case-mix adjustment to compare nationwide hospital performances after resection of colorectal liver metastases

Case-mix adjustment to compare nationwide hospital performances after resection of colorectal liver metastases

Shorter Survival after Liver Pedicle Clamping in Patients Undergoing Liver Resection for Hepatocellular Carcinoma Revealed by a Systematic Review and Meta-Analysis

Simultaneous or Staged Resection for Synchronous Liver Metastasis and Primary Rectal Cancer: A Propensity Score Matching Analysis

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