title: Disease-Free Survival after Simultaneous or Delayed Resection of Synchronous Colorectal Liver Metastasis and Primary Cancer.
abstract: OBJECTIVE
  The purpose of our study was to compare disease-free survival in patients with synchronous colorectal liver metastasis who underwent delayed hepatic resection or simultaneous resection.
  
  
  METHODS
  All patients who underwent a curative resection of synchronous colorectal liver metastasis between 2000 and 2006 in our tertiary care referral centre were retrospectively included in our study. Patients who underwent the first stage of a two-stage hepatectomy during the primary resection were included in the delayed resection group. Disease-free survival was studied using a Kaplan-Meier method. Prognostic factors for disease-free and overall survival were determined by multivariate analysis using Cox models.
  
  
  RESULTS
  One hundred and five patients underwent 85 delayed resections and 20 simultaneous resections. Three and five-year disease-free survival did not differ significantly between simultaneous (50% and 40%) and delayed (65% and 34%) resection groups (P = 0.47). Preoperative carcinoembryonic antigen (HR = 2.05, 95% CI, 1.07-3.92) and presence of extra-hepatic metastasis (HR = 2.85, 95% CI, 1.08-7.54) were independent prognostic factors for disease-free survival. Three and five-year overall survival did not differ either (23% and 23%; 24% and 20%, P = 0.13).
  
  
  CONCLUSIONS
  Simultaneous resection of synchronous colorectal liver metastasis and primitive cancer does not appear to impair long-term disease-free survival.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Bigourdan
authors.forename: Bernard
authors.initials: B
authors.lastname: Faber
authors.forename: Michel
authors.initials: M
authors.lastname: Rayar
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Chirpaz
authors.forename: Eveline
authors.initials: E
authors.lastname: Boucher
authors.forename: Karim
authors.initials: K
authors.lastname: Boudjema
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003082:Colectomy / Q000009:adverse effects / Q000401:mortality; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005602:France; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000209:etiology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome