SHORT-TERM RESULTS OF SURGICAL TREATMENT FOR SYNCHRONOUS LIVER METASTASES OF RECTAL CANCER

BACKGROUND. Staged surgery in cases of rectal cancer liver metastases is preferred method in routine clinical practice. Another choice is simultaneous operations. Our prospecpective study compares short-term outcomes of patients with synchronous rectal liver metastases treated by simultaneous or staged surgery. METHODS. 108 suitable patients were treated in State Scientific Centre of coloproctology named after A.N.Ryzhih, Moscow, Russia between January 2013 and February 2017. Simultaneous rectal and hepatic resections were performed in 78 patients; 30 patients underwent delayed hepatectomy. Short-term outcomes were analyzed. RESULTS. Major liver resections were rarely performed in group of simultaneous operations: 22 % vs 56% (р=0,0001). Anterior resection performed more often in simultaneous group 48/78 (62%) vs 12 (40%) (р=0,053), respectively. There was no difference in mortality and complications rates between major liver resections in both groups: 0 vs 3 % and 57% vs 28%, respectively. Age ≤61 y.o. (OR=13; 95 % CI=1,3-120), size of the largest metastasis in the liver >2.1 cm (OR=6,6; 95 % CI=1,8-23), staged surgery (OR=6,9; 95 % CI=1,5-31) were identified as independent risk factors of complications. CONCLUSION. Simultaneous operations, requiring economical resections are indicated in cases of synchronous metastases of rectal cancer in the liver. Simultaneous major R0 resections of the liver (till 70 % of livers parenchyma) done in specialized centers do not lead to increased complications, mortality rates and inpatient days.

synchronous colorectal cancer liver metastases, liver resections, rectal cancer, simultaneous resections

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