Background: This study evaluated the outcome of patients treated tor rectal cancer and synchronous hepatic metastases in the era of effective induction radiotherapy and chemotherapy. Methods: All patients undergoing surgical treatment of rectal cancer and synchronous liver metastases between 2000 and 2007 were identified retrospectively from a prospectively collected database. Three approaches were followed: the classical staged, the simultaneous and the liver-first approach. Results: Of 57 patients identified, the primary tumour was resected first in 29 patients (group 1), simultaneous resection was performed in eight patients (group 2), and 20 patients underwent a liver-first approach (group 3). The overall morbidity rate was 24-6 per cent; there was no in-hospital mortality. Median in-hospital stay was significantly shorter for the simultaneous approach (9 days versus 18 and 15 days for groups 1 and 3 respectively; P < 0.001). The overall S-year survival rate was 38 per cent, with an estimated median survival of 47 months. Conclusion: Long-term survival can be achieved using an individualized approach, with curative intent, in patients with rectal cancer and synchronous liver metastases. Simultaneous resections as well as the liver-first approach are attractive alternatives to traditional staged resections.

Kaplan Meier method, adult, aged, article, disease free survival, human, liver resection, liver tumor, metastasis, middle aged, mortality, multimodality cancer therapy, rectum tumor, time, tumor recurrence,
British Journal of Surgery
Erasmus MC: University Medical Center Rotterdam

van der Pool, A.E.M, de Wilt, J.H.W, Lalmahomed, Z.S, Eggermont, A.M.M, IJzermans, J.N.M, & Verhoef, C. (2010). Optimizing the outcome of surgery in patients with rectal cancer and synchronous liver metastases. British Journal of Surgery, 97(3), 383–390. doi:10.1002/bjs.6947