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Table 2 Large retrospective studies focusing on comparison of the simultaneous versus the staged approach for the treatment of colorectal cancer liver metastases

From: Unresolved issues and controversies surrounding the management of colorectal cancer liver metastasis

Author

N a

Year

Approach, n

Morbidity, %

Mortality, %

Conclusions

Capussotti [29]

79

2007

31 simul

33

0

Mortality rates are similar in both procedures, so the simultaneous procedure can be performed in carefully selected patients

48 staged

56

1,3

Lyass [25]

112

2001

26 simul

27

0

Because of lower mortality rates and similar OS compared to staged, Simultaneous resection is a safe and efficient procedure for the treatment of resectable SCRLM

86 staged

35

2.3

Bolton [35]

165

2000

50 simulb

nr

17

The mortality rate is higher if liver resection is combined with colorectal resection. Therefore, patients should have hepatic resection delayed for at least 3 months after colon resection

115 staged

nr

1

de Haas [42]

228

2010

55 simul

11

0

The simultaneous approach is safe for limited HR

   

173 staged

25

0.6

However, the higher recurrence rate observed in studied patients makes its oncological value and use in clinical practice questionable

Martin RC [33]

230

2009

70 simul

56

0

Morbidity and mortality rates are comparable in both procedures. Therefore, Simultaneous resection is an acceptable option in patients with resectable SCRLM

160 staged

55

4

Martin R [26]

240

2003

134 simul

49

2

Simultaneous resection should be considered a safe option in patients with resectable SCRLM, because it offers reduced morbidity, shorter treatment time, and similar survival outcomes

106 staged

67

2

Reddy [37]

610

2007

135 simul

36

1

Simultaneous resection is safe and should be considered for patients with SCRLM; however, due to higher morbidity compared to staged resection only in those patients whose hepatic tumor burden is amenable to minor liver resection (less than three segments)

475 staged

18

0.5

Nordlinger [34]

1008

1996

115 simul

nr

7

The mortality rate is increased when a major liver resection is performed simultaneously with the resection of the primary tumor

893 staged

nr

2

      

Therefore, this procedure is recommended only if it can be done with a minor liver resection and through the same abdominal incision

  1. aOnly those studies with N ≥50 were considered in this table.
  2. bLiver resection was carried out simultaneously with or within 3 months of colorectal resection.
  3. HR, hepatic resection; N, total number of patients; n, number of patients treated with simultaneous or staged resection; nr, not reported; SCRLM, simultaneous colorectal liver metastasis; simul, simultaneous resection of the primary tumor and SCRLM.