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Related Experiment Video

Updated: Jun 14, 2026

Application of Laparoscopic Hepatectomy Combined with Intraoperative Microwave Ablation in Colorectal Cancer Liver Metastasis
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Published on: March 3, 2023

Different Surgical Strategies in Colorectal Cancer Patients With Synchronous Liver Metastasis: A Meta-Analysis.

Haitham M Azmy1, Ali A Shafik1, Ahmed Hussein Ahmed1

  • 1General Surgery Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

The American Surgeon
|June 12, 2026
PubMed
Summary

For colorectal adenocarcinoma with liver metastases, no surgical approach (colon-first, liver-first, or simultaneous resection) shows a survival advantage. Treatment decisions should be individualized based on patient and disease factors.

Keywords:
colorectal cancerliversimultaneoussurgerysurvival

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Last Updated: Jun 14, 2026

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Published on: September 3, 2021

Area of Science:

  • Oncology
  • Surgical Oncology
  • Gastroenterology

Background:

  • Colorectal adenocarcinoma with synchronous liver metastases presents a complex treatment challenge.
  • Surgical sequencing strategies aim to optimize outcomes for these patients.
  • The optimal timing for resecting primary colorectal tumors and liver metastases remains debated.

Purpose of the Study:

  • To systematically review and compare short- and long-term outcomes of different surgical sequencing strategies for colorectal adenocarcinoma with synchronous liver metastases.
  • To evaluate overall survival (OS) at 1, 3, and 5 years for colon-first, liver-first, and simultaneous resection approaches.

Main Methods:

  • A comprehensive literature search was performed across major databases (PubMed, CENTRAL, Embase, Ovid, ScienceDirect).
  • Studies comparing surgical sequencing strategies in patients without extrahepatic disease were included.
  • Data were analyzed using Review Manager software, with outcomes expressed as odds ratios (ORs) or mean differences (MDs) with 95% confidence intervals (CIs).

Main Results:

  • No statistically significant differences in 1-, 3-, or 5-year overall survival were found among the colon-first, liver-first, and simultaneous resection strategies.
  • Simultaneous resection demonstrated comparable survival rates to the colon-first approach.
  • The liver-first approach also showed no significant difference in survival compared to the colon-first strategy.

Conclusions:

  • Current evidence suggests no single surgical sequencing strategy offers a definitive survival advantage for colorectal adenocarcinoma with synchronous liver metastases.
  • Individualized treatment decisions, considering patient characteristics and disease factors within a multidisciplinary framework, are recommended.
  • Further high-quality randomized controlled trials are warranted to establish optimal management guidelines.