Synchronous Rectal and Hepatic Resection of Rectal Metastatic Disease

Sarah York Boostrom, Liana Tsikitis Vassiliki, David M. Nagorney, Bruce G. Wolff, Heidi K. Chua, Scott Harmsen, David W. Larson

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    20 Scopus citations

    Abstract

    Background: The objectives were to determine the feasibility of combined rectal and hepatic resections and analyze the disease-free survival and overall survival. Study Design: Sixty patients who underwent resection for metastatic rectal disease from 1991 to 2005 at Mayo Clinic were reviewed. Inclusion criteria were: rectal cancer with metastatic liver disease and resectability of metastases. The exclusion criteria were: metachronous resection (n = 15). Kaplan-Meier Survival estimated overall survival (OS) and disease-free survival (DFS). Cox proportional hazard models examined the association between groups and survival. Results: The cohort comprised 22 men and 23 women, with median age of 63 years. Surgical management included: abdominoperineal resection, 13 patients (29%); low anterior resection, 29 (64%); local excision, one; total proctocolectomy, one; and pelvic exenteration, one. Major hepatic resection was performed in 22%. There was no mortality, but there were 26 postoperative complications. Disease-free survival from local recurrence at 1, 2, and 5 years was 92%, 86%, and 80%, respectively. Disease-free survival from distant recurrence at 1, 2, and 5 years was 62%, 43%, and 28%, respectively. Overall survival at 1, 2 and 5 years was 88%, 72%, and 32%, respectively. Conclusions: Combined rectal and hepatic resection is safe. Morbidity and mortality do not preclude concurrent resection. The DFS and OS are comparable to that of patients undergoing a staged procedure.

    Original languageEnglish (US)
    Pages (from-to)1583-1588
    Number of pages6
    JournalJournal of Gastrointestinal Surgery
    Volume15
    Issue number9
    DOIs
    StatePublished - Sep 1 2011

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    Keywords

    • Hepatic
    • Metastatic
    • Rectal
    • Synchronous

    ASJC Scopus subject areas

    • Surgery
    • Gastroenterology

    Cite this

    Boostrom, S. Y., Vassiliki, L. T., Nagorney, D. M., Wolff, B. G., Chua, H. K., Harmsen, S., & Larson, D. W. (2011). Synchronous Rectal and Hepatic Resection of Rectal Metastatic Disease. Journal of Gastrointestinal Surgery, 15(9), 1583-1588. https://doi.org/10.1007/s11605-011-1604-9