SIMULTANEOUS VS STAGED RESECTIONS IN COLON CANCER PATIENTS WITH SYNCHRONOUS LIVER METASTASES: PROGNOSTIC IMPACT OF...

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Synchronous liver metastases (SLM) in colon cancer (CC) patients indicate a poor prognosis.
• The prognostic impact of lymph node ratio (LNR) and tumor burden score (TBS) in CC with SLM is not fully understood.

Purpose of the Study:

• To evaluate the effect of LNR and TBS on survival in CC patients with synchronous liver metastases undergoing staged or simultaneous surgery.

Main Methods:

• Retrospective analysis of 365 CC patients with SLM who had surgical resection.
• LNR defined as metastatic to total harvested lymph nodes (cutoff 0.25).
• TBS calculated using Sasaki formula, categorized into risk groups.

Main Results:

• LNR (HR=3.1), TBS clusters (HR=1.8), pN stage (HR=0.6), number of liver metastases (HR=0.8), and KRAS status (HR=1.1) were independent risk factors for overall survival.
• High LNR and TBS were associated with poorer survival.

Conclusions:

• LNR and TBS aid in surgical strategy selection for CC patients with synchronous liver metastases.
• Staged surgery demonstrated superior oncological outcomes for patients with high LNR and TBS.