title: Simultaneous resection for rectal cancer with synchronous liver metastasis is a safe procedure.
abstract: BACKGROUND
  One quarter of colorectal cancer patients will present with liver metastasis at the time of diagnosis. Recent studies have shown that simultaneous resections are safe and feasible for stage IV colon cancer. Limited data are available for simultaneous surgery in stage IV rectal cancer patients.
  
  
  METHODS
  One hundred ninety-eight patients underwent surgical treatment for stage IV rectal cancer. In 145 (73%) patients, a simultaneous procedure was performed. Fifty-three (27%) patients underwent staged liver resection. A subpopulation of 69 (35%) patients underwent major liver resection (3 segments or more) and 30 (44%) patients with simultaneous surgery.
  
  
  RESULTS
  The demographics of the 2 groups were similar. Complication rates were comparable for simultaneous or staged resections, even in the group subjected to major liver resection. Total hospital stay was significantly shorter for the simultaneously resected patients (P < .01).
  
  
  CONCLUSIONS
  Simultaneous resection of rectal primaries and liver metastases is a safe procedure in carefully selected patients at high-volume institutions, even if major liver resections are required.
authors.affiliation: Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Surgery, Medical University Vienna, Vienna, Austria.
authors.forename: Gerd R
authors.initials: GR
authors.lastname: Silberhumer
authors.affiliation: Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Philip B
authors.initials: PB
authors.lastname: Paty
authors.affiliation: Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Larissa K
authors.initials: LK
authors.lastname: Temple
authors.affiliation: Department of Surgery, Hepatobiliary Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Raphael L C
authors.initials: RL
authors.lastname: Araujo
authors.affiliation: Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Denton
authors.affiliation: Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Mithat
authors.initials: M
authors.lastname: Gonen
authors.affiliation: Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Garret M
authors.initials: GM
authors.lastname: Nash
authors.affiliation: Department of Surgery, Hepatobiliary Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Allen
authors.affiliation: Department of Surgery, Hepatobiliary Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Ronald P
authors.initials: RP
authors.lastname: DeMatteo
authors.affiliation: Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Jose
authors.initials: J
authors.lastname: Guillem
authors.affiliation: Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Martin R
authors.initials: MR
authors.lastname: Weiser
authors.affiliation: Department of Surgery, Hepatobiliary Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Michael I
authors.initials: MI
authors.lastname: D'Angelica
authors.affiliation: Department of Surgery, Hepatobiliary Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: William R
authors.initials: WR
authors.lastname: Jarnagin
authors.affiliation: Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Wong
authors.affiliation: Department of Surgery, Hepatobiliary Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA. Electronic address: yfong@coh.org.
authors.forename: Yuman
authors.initials: Y
authors.lastname: Fong
mesh_terms: D000328:Adult; D000368:Aged; D003082:Colectomy / Q000379:methods*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007902:Length of Stay; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000453:epidemiology; D012004:Rectal Neoplasms / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Complications; Simultaneous resection; Stage IV rectal cancer