Simultaneous approach of primary colorectal carcinoma and liver metastases

Background: Optimal surgical approach to synchronous colorectal liver metastases is a subject of debate. Aims: This retrospective study compares the outcomes of patients undergoing simultaneous resection or delayed resection. Methods: All 238 patients undergoing liver resection between 1995 and 2014 for liver only resectable synchronous colorectal metastases were included in this study. Outcomes were compared between patients undergoing simultaneous resection and delayed resection. Results: The morbidity and mortality rates were similar between the two groups p value > 0.05), even in patients with rectal tumors or undergoing major hepatectomies. The overall survival rates achieved in the SR group were not significantly lower than in DR group p value = 0.817), either in N-positive patients, or in patients presenting multiple liver metastases. Conclusion: Simultaneous resection provides similar morbidity, mortality and survival rates as delayed resection, even in N-positive patients or those with primary rectal tumors, multiple metastases or undergoing major hepatectomies.