title: [Simultaneous versus staged liver resection of synchronous liver metastasis from colorectal cancer].
abstract: OBJECTIVE
  To compare the short- and long-term outcomes of patients with synchronous colorectal liver metastases receiving either simultaneous or staged hepatectomy.
  
  
  METHODS
  Clinical and follow-up data of 64 patients with synchronous colorectal liver metastasis who underwent either simultaneous or staged hepatectomy between January 2003 and December 2011 in our hospital were reviewed retrospectively. Among them 20 patients underwent simultaneous resection of colorectal cancer and liver metastasis(simultaneous group) and 44 patients underwent staged operations(staged group).
  
  
  RESULTS
  The Clavien-Dindo grade 1, 2, 3 complication rates in simultaneous group were 10.0%, 15.0% and 15.0% respectively, and were staged group 13.6%, 13.6% and 22.7% respectively in staged group, and the difference was not statistically significant(P>0.05). The 1-, 2- and 3-year overall survival rates in simultaneous group were 85.0%, 59.6% and 37.2% respectively, compared with 90.9%, 68.2% and 47.1% in staged group, and the difference was not statistically significant(P>0.05). The median disease-free survival time in simultaneous group was 6 months versus 7 months in the staged group, which was comparable(P>0.05). Multivariate analysis revealed that positive primary lymph-node(P=0.020), prehepatectomy CEA>20 μg/L(P=0.017) were independent risk factors of overall survival, and having the opportunity to receive local radical therapy combined with chemotherapy after recurrence was a protective factor(P=0.001), while the timing of resection (simultaneous or staged strategy) did not reach statistical significance according to overall survival(P>0.05).
  
  
  CONCLUSIONS
  For synchronous colorectal liver metastasis there are no significant differences in postoperative complication rate and long-term survival between curative simultaneous and staged resection.
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education), Department of Hepatopancreaticobiliary Surgery, Peking University Cancer Hospital and Institute, Beijing 100142, China. xingbaocai88@sina.com.
authors.forename: Lijun
authors.initials: L
authors.lastname: Wang
authors.forename: Xiaoluan
authors.initials: X
authors.lastname: Yan
authors.forename: Kun
authors.initials: K
authors.lastname: Wang
authors.forename: Quan
authors.initials: Q
authors.lastname: Bao
authors.forename: Yi
authors.initials: Y
authors.lastname: Sun
authors.forename: Hongwei
authors.initials: H
authors.lastname: Wang
authors.forename: Kemin
authors.initials: K
authors.lastname: Jin
authors.forename: Baocai
authors.initials: B
authors.lastname: Xing
mesh_terms: D015179:Colorectal Neoplasms / Q000473:pathology*; D018572:Disease-Free Survival; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D012189:Retrospective Studies; D015996:Survival Rate