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Erik Reiter

Erik Reiter

Otto-von-Taube Gymnasium

Titel der Forschungsarbeit: Simultaneous versus staged resection of colorectal cancer and synchronous liver metastases:  A retrospective, single center, follow-up study

School: TUM School of Medicine and Health

Department: Medizin

Lehrstuhl: Klinik und Poliklinik für Chirurgie

Betreuung: Dr. Nick Seyfried

Abstract der Forschungsarbeit

Background: Surgical treatment of colorectal cancer with synchronous liver metastases is at present seen as standard of care. The surgical treatment offers two different possible approaches, the two staged or the simultaneous resection of the primary colorectal tumor and the liver metastases. Currently, there is no consensus on the most favorable approach.

Materials and Methods: This is a retrospective study. Patients who underwent resection of both the primary colorectal tumor and liver metastases at the University hospital “TUM Klinkum rechts der Isar” between 2017 and 2022 were included. Clinical, histopathologic, serologic and survival data were analyzed. Outcomes included overall survival, postoperative complications and average length of surgery and hospital stay.

Results: Overall, 36 patients underwent resection of the primary tumor and synchronous liver metastases. Resection was performed simultaneously in 15 patients and in two sessions in 21 patients. Patient outcomes and characteristics were mostly comparable. We found a shorter average length of total hospital stay (23 days versus 32 days; p = 0.155) and length of total surgery time (391 min versus 577min; p = 0.328) for the simultaneous resection group compared to the staged resection patients. Kaplan-Meier analysis showed no significant differences in peri- and postoperative mortality between the two groups. The postoperative rate of complications showed no significant difference. The overall survival (p = 0.725) was similar between the two groups but the disease recurrency seemed slightly higher for the simultaneous group (100% versus 75%; p = 0.614).

Conclusion: The simultaneous resection of the primary colorectal tumor and liver metastases may be favorable compared to the staged resection in terms of length of hospital stay and total surgery time. The simultaneous approach is not inferior to the staged approach in terms of postoperative mortality and complications and can therefore be regarded as a safe procedure. More studies in larger patient cohorts are needed to shed further light on this issue.