title: Long-term oncologic outcomes for simultaneous resection of synchronous metastatic liver and primary colorectal cancer.
abstract: Twenty-five percent of patients with colorectal cancer present with simultaneous liver metastasis. Complete resection is the only potential curative treatment. Due to improvements in operative and perioperative management, simultaneous liver and colon resections are an accepted procedure at specialized centers for selected patients. Nevertheless, little is known about the long-term, oncologic results of simultaneous operative procedures compared with those of staged operations.
  
  
  
  Patients with colorectal cancer and simultaneous liver metastases presenting for complete resection at a tertiary cancer center were identified. Patients who received the primary colon resection at an outside institution were excluded from analysis.
  
  
  
  Between 1984 and 2008, 429 patients underwent operative treatment for colorectal cancer with simultaneous liver metastasis. Of these, 320 (75%) had simultaneous resection and 109 had staged resection. There was no difference in the distribution of primary tumor locations between the 2 groups. Mean size of the hepatic metastases was significantly greater in the staged group (median 4 cm vs 2.5 cm; P < .01). Neither disease-free nor overall survival differed significantly between the 2 treatment strategies. The extent of the liver procedure (more than 3 segments) was identified as a risk factor for decreased disease-free and overall survival (both P < .01).
  
  
  
  Simultaneous liver and colorectal resections for metastatic colorectal cancer are associated with similar long-term cancer outcome compared with staged procedures.
authors.affiliation: Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY; 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.
authors.forename: Philip B
authors.initials: PB
authors.lastname: Paty
authors.affiliation: Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Brian
authors.initials: B
authors.lastname: Denton
authors.affiliation: Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Jose
authors.initials: J
authors.lastname: Guillem
authors.affiliation: Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Mithat
authors.initials: M
authors.lastname: Gonen
authors.affiliation: Department of Surgery, Hepatobiliary Service, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Raphael L C
authors.initials: RLC
authors.lastname: Araujo
authors.affiliation: Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Garret M
authors.initials: GM
authors.lastname: Nash
authors.affiliation: Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY.
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.
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.
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.
authors.forename: Martin R
authors.initials: MR
authors.lastname: Weiser
authors.affiliation: Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: W Douglas
authors.initials: WD
authors.lastname: Wong
authors.affiliation: Department of Surgery, Hepatobiliary Service, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: William R
authors.initials: WR
authors.lastname: Jarnagin
authors.affiliation: Department of Surgery, Hepatobiliary Service, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Michael I
authors.initials: MI
authors.lastname: D'Angelica
authors.affiliation: Department of Surgery, City of Hope, Duarte, CA. Electronic address: yfong@coh.org.
authors.forename: Yuman
authors.initials: Y
authors.lastname: Fong
mesh_terms: D000328:Adult; D000368:Aged; D003082:Colectomy; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome