[Delayed hepatic resection for synchronous liver metastases from colorectal cancer]

This study aimed to compare the surgical outcome and long-term survival between simultaneous and delayed resection of liver metastases from colorectal cancer (LM).

Seventy-four patients with LM were divided into two groups, i. e., 32 patients who underwent hepatectomy at the time of colorectal surgery (simultaneous group) and 35 patients who underwent delayed liver resection (delayed group).

In 12 of the 35 (34%) patients from the delayed group, new metastatic lesions were found in the same and/or different segments after re-evaluation during the interval between operations. These patients had a shorter interval between procedures, and larger tumors than patients without tumor progression. There were significant differences (p=0.0454 and 0.0077) of hepatic disease-free survival between the metachronous or delayed groups and the simultaneous group. Multivariate analysis showed that simultaneous resection was one of three independent prognostic indicators with an influence on hepatic disease-free survival.

Tumor progression could be recognized and occult metastases were detected during the interval between operations. Delayed resection of synchronous LM may be useful to reduce the risk of rapid recurrence in the remnant liver.