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Prognostic Analysis of 102 Patients with Synchronous Colorectal Cancer and Liver Metastases Treated with simultaneous resection

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Chinese Medical Journal 2017年第11期130卷 1283-1289页

作者： Rui Mao Xiao Chen Jian-Jun Zhao Xin-Yu Bi Zhi-Yu Li Jian-Guo Zhou Hong Zhao Zhen Huang Yong-Kun Sun Jian-Qiang Cai Department of Hepatobiliary Surgery National Cancer Center/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100021 China Department of Medical Oncology National Cancer Center/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100021 China

Background： The liver is the most common site for colorectal cancer （CRC） metastases. Their removal is a critical and challenging aspect of CRC treatment. We investigated the prognosis and risk factors of patients with CRC and liver metastases （CRCLM） who underwent simultaneous resections for both lesions. Methods： From January 2009 to August 2016, 102 patients with CRCLM received simultaneous resections of CRCLM at our hospital. We retrospectively analyzed their clinical data and analyzed their outcomes. Overall survival （OS） and disease-free survival （DFS） were examined by Kaplan-Meier and log-rank methods. Results： Median follow-up time was 22.7 months： no perioperative death or serious complications were observed. Median OS was 55.5 months： postoperative OS rates were l-year： 93.8%, 3-year： 60.7%, and 5-year： 46.4%. Median DFS was 9.0 months; postoperative DFS rates were l-year： 43.1%, 3-year： 23.0%, and 5-year 21.1%. Independent risk factors found in multivariate analysis included carcinoembryonic antigen 〉100 ng/ml, no adjuvant chemotherapy, tumor thrombus in liver metastases, and bilobar liver metastases for OS; age 〉60 years, no adjuvant chenlotherapy, multiple metastases, and largest diameter ≥3 cm for DFS. Conclusions： simultaneous surgical resection is a safe and effective treatment for patients with synchronous CRC LM. The main prognostic factors are pathological characteristics of liver metastases and whether standard adjuvant chemotherapy is performed.

关键词： Colorectal Cancer Liver Metastases Prognosis simultaneous resection

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simultaneous hepatic resection benefits patients with synchronous colorectal cancer liver metastases

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Chinese Journal of Cancer Research 2016年第5期28卷 528-535页

作者： Yuan Li Xinyu Bi Jianjun Zhao Zhen Huang Jianguo Zhou Zhiyu Li Yefan Zhang Hong Zhao Jianqiang Cai Department of Abdominal Surgery Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical College

Objective： The safety of the simultaneous resection of synchronous colorectal cancer liver metastases （SCRLM） is still being debated. However, this simultaneous operative approach is more commonly adopted at present than in the past. Therefore, we compared simultaneous hepatic resection with delayed hepatic resection in this ***： All patients with SCRLM diagnosed before initial treatment between January 2009 and September 2013 were retrospectively included in our study. Short-term and long-term outcomes were compared in patients who underwent simultaneous colorectal and hepatic resection and those treated by delayed ***： Among the 73 patients diagnosed with SCRLM, simultaneous coloreetal and hepatic resection was performed in 60 patients （82.2%）, while delayed hepatic resection was performed in 13 patients （17.8%）. The mortality rate was zero. The postoperative complication rate after delayed resection was higher than, but not significantly different from, that after simultaneous resection （46% vs. 23%, P=0.166）. The duration of operating time （240 vs. 420 min, P〈0.05） and postoperative hospital stay time （11 vs. 18 days, P〈0.05） were shorter in the simultaneous resection group. After the initial treatments were given, the 1-, 2-, and 3-year survival rates in the simultaneous resection group were 77%, 59%, and 53%, respectively, whereas those in the delayed resection group were 67%, 42%, and 10%, respectively. The 5-year survival rate in the simultaneous resection group was 23%; overall survival differed significantly between the two groups （P=0.037）. Median disease-free survival （DFS） times were 19.1 months in the simultaneous resection group and 8.8 months in the delayed resection group. DFS differed significantly between the two groups. Coenclusions： simultaneous colorectal and hepatic resection is safe and exhibits advantages in the longtime survival of patients.

关键词： Colorectal cancer synchronous liver metastases simultaneous resection survival

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simultaneous colorectal and parenchymal-sparing liver resection for advanced colorectal carcinoma with synchronous liver metastases:Between conventional and mini-invasive approaches

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World Journal of Gastroenterology 2020年第42期26卷 6529-6555页

作者： Emilio De Raffele Mariateresa Mirarchi Dajana Cuicchi Ferdinando Lecce Riccardo Casadei Claudio Ricci Saverio Selva Francesco Minni Division of Pancreatic Surgery Department of Digestive DiseasesAzienda Ospedaliero-Universitaria di BolognaPoliclinico S.Orsola-Malpighi40138 BolognaItaly Dipartimento Strutturale Chirurgico Ospedale SS Antonio e Margherita15057 Tortona(AL)Italy Surgery of the Alimentary Tract Department of Digestive DiseasesAzienda Ospedaliero-Universitaria di BolognaPoliclinico S.Orsola-Malpighi40138 BolognaItaly Division of Pancreatic Surgery Department of Medical and Surgical Sciences(DIMEC)Alma Mater StudiorumUniversity of Bologna40138 BolognaItaly

The optimal timing of surgery in case of synchronous presentation of colorectal cancer and liver metastases is still under *** approach,with initial colorectal resection followed by liver resection(LR),or even the reverse,liver-first approach in specific situations,is traditionally *** resections,however,represent an appealing strategy,because may have perioperative risks comparable to staged resections in appropriately selected patients,while avoiding a second surgical *** patients with larger or multiple synchronous presentation of colorectal cancer and liver metastases,simultaneous major hepatectomies may determine worse perioperative outcomes,so that parenchymal-sparing LR should represent the most appropriate option whenever ***-invasive colorectal surgery has experienced rapid spread in the last decades,while laparoscopic LR has progressed much slower,and is usually reserved for limited tumours in favourable ***,mini-invasive parenchymal-sparing LR is more complex,especially for larger or multiple tumours in difficult *** remains to be established if simultaneous resections are presently feasible with mini-invasive approaches or if we need further technological advances and surgical expertise,at least for more complex *** review aims to critically analyze the current status and future perspectives of simultaneous resections,and the present role of the available miniinvasive techniques.

关键词： Synchronous colorectal liver metastases Colorectal surgery Liver surgery simultaneous resection Parenchymal-sparing liver resection Mini-invasive surgery Intraoperative ultrasonography

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simultaneous laparoscopy-assisted low anterior resection and distal gastrectomy for synchronous carcinoma of rectum and stomach

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World Journal of Gastroenterology 2008年第21期14卷 3435-3437页

作者： Qian-Lin Zhu,Min-Hua Zheng,Bo Feng,Ai-Guo Lu,Min-Liang Wang,Jian-Wen Li,Wei-Guo Hu,Lu Zang,Zhi-Hai Mao,Feng Dong,Jun-Jun Ma,Ya-Ping Zong,Department of General Surgery,Ruijin Hospital Affiliated to Shanghai Jiaotong University Shanghai Minimally Invasive Surgery Center,Shanghai 200025,China Department of General Surgery Ruijin Hospital Affiliated to Shanghai Jiaotong University Shanghai Minimally Invasive Surgery Center Shanghai 200025 China. zqlalani@***

Laparoscopic resection of rectal cancer or gastric cancer has been advocated for the benefits of a reduced morbidity,a shorter treatment time,and similar ***,simultaneous laparoscopy-assisted low anterior resection and distal gastrectomy for synchronous carcinoma of rectum and stomach are rarely documented in *** examination revealed a synchronous carcinoma of rectum and stomach in a 55-year-old male patient with rectal bleeding and epigastric *** underwent a simultaneous laparoscopy-assisted low anterior resection and distal gastrectomy with regional lymph nodes *** operation time was 270 min and the estimated blood loss was 120 *** patient required parenteral analgesia for less than 24 *** was passed on postoperative day 3,and a solid diet was resumed on postoperative day *** was discharged on postoperative day *** the advances in laparoscopic technology and experience,simultaneous resection is an attractive alternative to a synchronous gastrointestinal cancer.

关键词： Laparoscopy Gastric cancer Rectal cancer simultaneous resection Synchronous carcinoma

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Synchronous left atrial myxoma and adenosquamous lung carcinoma

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Chinese Medical Journal 2013年第15期126卷 2992-2993页

作者： LIU Hong-cheng CHEN Xiao-feng YU Yu-ming JIANG Ge-ning Tongji Univ Dept Thorac Surg Shanghai Pulm Hosp Sch Med Shanghai 200433 Peoples R China

Atrial myxomas account for 40%-50% of primary cardiac tumors and as such are the most common primary heart tumors. Because prolapsing myxomas cause the intermittent obstruction of the valvular outflow tract during diastole, the signs and symptoms of left atrial myxoma resemble mitral stenosis. Myxoma may lead to systemic thromboembolic events from tumor fragmentation. In addition, lung carcinoma is a common tumor with highly heterogeneous malignancies.

关键词： left atrial myxoma lung carcinoma synchronous occurrence simultaneous resection

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