Simultaneous Approach of Colo-Rectal and Hepatic Lesions in Colo-Rectal Cancers with Liver Metastasis - A Single Oncological Center Overview

• Published in: Chirurgia (Bucharest, Romania : 1990) Vol. 118; no. 3; pp. 237 - 249
• Main Authors: Simion, Laurenţiu, Rotaru, Vlad, Cirimbei, Simona, Chitoran, Elena, Galeş, Laurenţia, Luca, Dan Cristian, Ionescu, Sînziana, Tanase, Bogdan, Ginghină, Octav, Mihnea, Alecu, Voinea, Silviu, Bîrligea, Andra, Doran, Horia, Cirimbei, Ciprian
• Format: Journal Article
• Language: English
• Published: Romania 01.06.2023
• Subjects: Digestive System Diseases; Humans; Liver Neoplasms - surgery; Rectal Neoplasms; Retrospective Studies; Treatment Outcome; colo-rectalcancer; livermetastasis; surgicaltreatment; chemotherapy; simultaneousapproach
• ISSN: 1221-9118
• DOI: 10.21614/chirurgia.2023.v.118.i.3.p.237

Management of synchronous colorectal cancer with liver metastases (SCLM) is still on debate, regarding timing, indications and complications of the 3 strategies: classic approach (first tumor resection), simultaneous resection and reverse approach (liver first). A retrospective single-centre evaluation of synchronous approach was accomplished, focusing on surgical technique, indications and complications. Material and Between 2017 and 2020, 31 SCLM patients benefited from synchronously colorectal and hepatic approach: segmental colectomies/rectal resections, simultaneously with liver metastasectomies (associated with radiofrequency ablation). Post-therapeutic imaging monitoring was performed from every 3 - 6 months. There were no perioperative complications related to the combination of the procedures, low morbidity and zero postoperative mortality. The follow-up period was 10 - 40 months: 13 patients had no evidence of recurrence, 10 had hepatic metastases in regression, 4 patients had signs of peritoneal carcinomatosis and 4 showed progression of liver disease; all patients were on chemotherapy. During follow-up 4 patients died. Experience shows that the simultaneous approach of recto-colic and hepatic resections in colo-rectal cancers is a safe procedure, with low morbidity, the limits being dictated by the size of the liver metastases. The results at long-distance must be drawn by further consistent trials.