Analysis Of Outcomes In Patients Undergoing Simultaneous Resection Of Synchronous Colorectal Liver Metastasis

Objective:Colorectal cancer is one of the most common malignant tumors.Liver is the most common metastasis site of colorectal cancer.The development of liver metastasis is the leading cause of death of patients with colorectal cancer.Surgical resection of primary and metastatic lesion is the best treatment for patients with colorectal liver metastases.There are two types of surgical procedure of synchronous colorectal liver metastasis,one is simultaneous hepatectomy,another is staged hepatectomy.But which one is better is under controversy.This research is to analyze short-term and long-term outcomes and related risk factors in patients undergoing simultaneous resection of synchronous colorectal liver metastasis.Methods:Clinicopathological and follow-up date of patients with synchronous colorectal liver metastasis who underwent simultaneous resection between January 1,2015 and March 1,2017 were collected and analyzed retrospectively.There were 49 patients with the inclusion criteria and exclusion criteria,and all patients were followed up for 1-3years.All patients were discussed and developed the treatment plan by the gastrointestinal and anal surgery,hepatobiliary pancreatic surgery,and oncology,etc.The operation was performed by a fixed gastrointestinal and anal surgery and hepatobiliary surgical team.SPSS21.0 software was used to analyze all data.The two groups were compared between by using ?2.Multiple prognostic factors were analysed by Logistic.P < 0.05 indicates that the difference is statistically significant.Results:Perioperative mortality was 2%.Perioperative complication was 36.7%(18/49).Patients with complications were all successfully treated,and there was no Reoperation case.The 1-year survival rate was 93.9%,and the 1-year disease-free survival rate was 59.2%.Single factor analysis revealed that number of metastasis focus: >1(p=0.002),hepatic tumor in bilateral liver(p=0.011),RAS gene mutant-type was 71.0%,(p=0.028)were risk factors of early recurrence.Multivariate analysis revealed that Number of liver metastases: > 1(p=0.005),RAS gene mutant-type(p=0.042)were independent risk factors of early recurrence.Sex,Age,Location of primary tumor,TNM,N-staging,Degree of differentiation,Vascularization,Perineural infiltration,The maximum diameter of lesions on liver is over 5 centimeter,Anatomical hepatectomy,The level of CEA before hepatectomy > 200 ng/ml,Resectable colorectal liver metastasis and Complications were uncorrelated with early recurrence.Conclusions:Simultaneous resection of synchronous colorectal liver metastasis is safe.Number of liver metastases: > 1,RAS gene mutant-type were independent risk factors of early recurrence.