Role of Surgical Approach to Synchronous Colorectal Liver Metastases: A Retrospective Analysis

Area of Science:

• Hepatobiliary Surgery
• Surgical Oncology
• Gastroenterology

Background:

• Synchronous colorectal liver metastasis (SCLM) presents a complex clinical challenge.
• Optimal management strategies for SCLM are crucial for improving patient survival and quality of life.

Purpose of the Study:

• To retrospectively analyze the efficacy of surgical management in patients with SCLM.
• To evaluate the impact of different surgical approaches on survival and cost-effectiveness.

Main Methods:

• Analysis of 953 SCLM patients from January 2006 to December 2015.
• Evaluation of surgical indications for liver metastases, simultaneous vs. staged resection, and primary tumor resection (PTR) in specific patient subgroups.

Main Results:

• Resected liver metastases significantly improved median survival (47.3 months) and 5-year survival (31%) compared to nonoperative treatment (17.2 months, 4%).
• Enlarging resection criteria increased resection rates (31.0% vs. 13.6%).
• Simultaneous resection was more cost-effective than staged resection (36,698 vs. 45,134 RMB). PTR improved survival in asymptomatic patients with unresectable metastases (18.0 vs. 15.0 months).

Conclusions:

• Liver resection is the preferred treatment for SCLM.
• Expanding liver resection indications improves resection rates.
• Simultaneous resection is recommended for resectable SCLM, while PTR is advised for asymptomatic patients with unresectable liver metastases.