Perioperative Outcomes of Simultaneous Colorectal and Liver Resections

Study Overview
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Brief Summary
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The use of a simultaneous resection in patients with synchronous colorectal liver metastases has increased over the past decades. However, it remains unclear when a simultaneous resection is beneficial and when it should be avoided. The objective of this retrospective study is therefore to compare the outcomes of a simultaneous resection for synchronous colorectal liver metastases in different settings, and to assess which factors are independently associated with unfavorable outcomes.

Official Title
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Simultaneous Resection of Colorectal Cancer and Synchronous Liver Metastases: What Determines the Risk of Unfavorable Outcomes? A Retrospective International Multicenter Study

Conditions
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Colorectal Cancer Metastatic, Surgical Procedure, Unspecified

Intervention / Treatment
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* Procedure: Major liver resection
* Procedure: Technically major liver resection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Elective minimally invasive or open simultaneous resection of colorectal cancer and synchronous colorectal liver metastases Exclusion Criteria: (Partially) robotic-assisted or thoracoscopic procedures First stage of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) Patients that underwent major concurrent procedures

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Minor liver resection<br>Minor liver resection (<3 contiguous segments) in the anterolateral segments | |
| Technically major liver resection<br>Minor liver resection (<3 contiguous segments) in the posterosuperior segments (Segment 1,4a,7,8) | Procedure: Technically major liver resection<br>* Minor liver resection (<3 contiguous segments) in the posterosuperior segments (segment 1,4a,7,8)<br>|
| Major liver resection<br>Major liver resection (3 or more contiguous segments) | Procedure: Major liver resection<br>* Major liver resection (3 or more contiguous segments)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Major complications | Severe complications (Clavien-Dindo grade 3a or higher) related to the surgical procedure | 30 days postoperatively | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Overall complications | Overall complications related to the surgical procedure | 30 days postoperatively | 
| Length of hospital stay | The length of hospital stay for the surgical procedure | 30 days postoperatively | 
| R0 resection margin | Proportion of patients in whom a microscopically radical resection of both the primary colorectal carcinoma and the liver metastases was performed. | 30 days postoperatively | 
| Intraoperative blood loss | Intraoperative blood loss in milliliters | During the surgical procedure | 
| Operative time | Operative time in minutes | During the surgical procedure | 
| Conversion to open surgery | Intra-operative conversion to an open or hand-assisted procedure in the minimally invasive group | During the surgical procedure | 
| Mortality | Postoperative mortality | 90 days postoperatively | 
| Red blood cell transfusion | Intraoperative red blood cell transfusion | During the surgical procedure | 
| Intraoperative incidents | Intraoperative unfavourable incidents | During the surgical procedure | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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colorectal cancer, synchronous colorectal liver metastases, simultaneous resection, postoperative outcomes