Simultaneous versus staged colorectal and hepatic resections for colorectal cancer with synchronous hepatic metastases: a meta-analysis of outcomes and clinical characteristics
Objectives To evaluate the comparative outcomes and clinical characteristics of simultaneous and staged colorectal and hepatic resections for colorectal cancer with synchronous hepatic metastases. Methods We conducted a systematic search of electronic information sources, and bibliographic reference...
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| Veröffentlicht in: | International journal of colorectal disease 2020-09, Vol.35 (9), p.1629-1650 |
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| container_title | International journal of colorectal disease |
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| creator | Hajibandeh, Shahin Hajibandeh, Shahab Sultana, Abida Ferris, Gabriella Mwendwa, Josiah Mohamedahmed, Ali Yasen Y. Zaman, Shafquat Peravali, Rajeev |
| description | Objectives
To evaluate the comparative outcomes and clinical characteristics of simultaneous and staged colorectal and hepatic resections for colorectal cancer with synchronous hepatic metastases.
Methods
We conducted a systematic search of electronic information sources, and bibliographic reference lists. Perioperative morbidity and mortality, anastomotic leak, wound infection, bile leak, bleeding, intra-abdominal abscess, sub-phrenic abscess, reoperation, recurrence, 5-year overall survival, procedure time, and length of hospital stay were the evaluated outcome parameters. Combined overall effect sizes were calculated using random-effects model.
Results
We identified 41 comparative studies reporting a total of 12,081 patients who underwent simultaneous (
n
= 5013) or staged (
n
= 7068) resections for colorectal cancer with synchronous hepatic metastases. There were significantly lower use of neoadjuvant chemotherapy (
p
= 0.003), higher right-sided colonic resections (
p
|
| doi_str_mv | 10.1007/s00384-020-03694-9 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2423516378</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A714487616</galeid><sourcerecordid>A714487616</sourcerecordid><originalsourceid>FETCH-LOGICAL-c419t-948af09ad010ff276511ac11e2468788aca908ec234f8a42906027161b1105453</originalsourceid><addsrcrecordid>eNp9ks-KFDEQxhtRcBx9AU8BL156N0mn02lvy-I_WPCgnkOZqZ7J0p2MqbQyb7WPaHpaWRWRHIoqft-XVPiq6rngF4Lz7pI4b4yqueQ1b3Sv6v5BtRGqkbWQWj6sNlx0fS361jyunhDd8tLrTm2qu49-mscMAeNM7BsmKoUy7HHHXBxjQpdhZBB27IBHyN6xhFSGPgZiQ0y_Uw6Cw8S--3xgdArukGJYbH8pJ8xQvAnpFYNzV0OA8USeWBxYnLOLE9L5Njf64N1ieoAELmPyVDzoafVogJHw2c-6rT6_ef3p-l198-Ht--urm9op0ee6VwYG3sOOCz4MstOtEOCEQKm06YwBBz036GSjBgNK9lxz2QktvgjBW9U22-rl6ntM8euMlO3kyeE4rl9lpZJNK3TTmYK--Au9jXMqiy1UIzTvpG7uqT2MaH0YYi57Lab2qhNKmU4Xu2118Q-qnB1O3sWAgy_zPwRyFbgUiRIO9pj8BOlkBbdLNuyaDVuyYc_ZsH0RNauIChz2mO5f_B_VDwgcvlA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2431607263</pqid></control><display><type>article</type><title>Simultaneous versus staged colorectal and hepatic resections for colorectal cancer with synchronous hepatic metastases: a meta-analysis of outcomes and clinical characteristics</title><source>SpringerLink Journals - AutoHoldings</source><creator>Hajibandeh, Shahin ; Hajibandeh, Shahab ; Sultana, Abida ; Ferris, Gabriella ; Mwendwa, Josiah ; Mohamedahmed, Ali Yasen Y. ; Zaman, Shafquat ; Peravali, Rajeev</creator><creatorcontrib>Hajibandeh, Shahin ; Hajibandeh, Shahab ; Sultana, Abida ; Ferris, Gabriella ; Mwendwa, Josiah ; Mohamedahmed, Ali Yasen Y. ; Zaman, Shafquat ; Peravali, Rajeev</creatorcontrib><description>Objectives
To evaluate the comparative outcomes and clinical characteristics of simultaneous and staged colorectal and hepatic resections for colorectal cancer with synchronous hepatic metastases.
Methods
We conducted a systematic search of electronic information sources, and bibliographic reference lists. Perioperative morbidity and mortality, anastomotic leak, wound infection, bile leak, bleeding, intra-abdominal abscess, sub-phrenic abscess, reoperation, recurrence, 5-year overall survival, procedure time, and length of hospital stay were the evaluated outcome parameters. Combined overall effect sizes were calculated using random-effects model.
Results
We identified 41 comparative studies reporting a total of 12,081 patients who underwent simultaneous (
n
= 5013) or staged (
n
= 7068) resections for colorectal cancer with synchronous hepatic metastases. There were significantly lower use of neoadjuvant chemotherapy (
p
= 0.003), higher right-sided colonic resections (
p
< 0.00001), and minor hepatic resections (
p
< 0.00001) in the simultaneous group. The simultaneous resection was associated with significantly lower rate of bleeding (OR 0.60,
p
= 0.03) and shorter length of hospital stay (MD − 5.40,
p
< 0.00001) compared to the staged resection. However, no significant difference was found in perioperative morbidity (OR1.04,
p
= 0.63), mortality (RD 0.00,
p
= 0.19), anastomotic leak (RD 0.01,
p
= 0.33), bile leak (OR 0.83,
p
= 0.50), wound infection (OR 1.17,
p
= 0.19), intra-abdominal abscess (RD 0.01,
p
= 0.26), sub-phrenic abscess (OR 1.26,
p
= 0.48), reoperation (OR 1.32,
p
= 0.18), recurrence (OR 1.33,
p
= 0.10), 5-year overall survival (OR 0.88,
p
= 0.19), or procedure time (MD − 23.64,
p
= 041) between two groups.
Conclusions
Despite demonstrating nearly comparable outcomes, the best available evidence (level 2) regarding simultaneous and staged colorectal and hepatic resections for colorectal cancer with synchronous hepatic metastases is associated with major selection bias. It is time to conduct high-quality randomised studies with respect to burden and laterality of disease. We recommend the staged approach for complex cases.</description><identifier>ISSN: 0179-1958</identifier><identifier>EISSN: 1432-1262</identifier><identifier>DOI: 10.1007/s00384-020-03694-9</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Abscesses ; Anastomotic leak ; Bile ; Bleeding ; Cancer ; Chemotherapy ; Colorectal cancer ; Colorectal carcinoma ; Comparative analysis ; Gastroenterology ; Health aspects ; Hepatology ; Infection ; Internal Medicine ; Liver ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Meta-analysis ; Metastases ; Metastasis ; Morbidity ; Mortality ; Proctology ; Review ; Surgery ; Survival ; Wound infection</subject><ispartof>International journal of colorectal disease, 2020-09, Vol.35 (9), p.1629-1650</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020</rights><rights>COPYRIGHT 2020 Springer</rights><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c419t-948af09ad010ff276511ac11e2468788aca908ec234f8a42906027161b1105453</citedby><cites>FETCH-LOGICAL-c419t-948af09ad010ff276511ac11e2468788aca908ec234f8a42906027161b1105453</cites><orcidid>0000-0001-6159-1068</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00384-020-03694-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00384-020-03694-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27926,27927,41490,42559,51321</link.rule.ids></links><search><creatorcontrib>Hajibandeh, Shahin</creatorcontrib><creatorcontrib>Hajibandeh, Shahab</creatorcontrib><creatorcontrib>Sultana, Abida</creatorcontrib><creatorcontrib>Ferris, Gabriella</creatorcontrib><creatorcontrib>Mwendwa, Josiah</creatorcontrib><creatorcontrib>Mohamedahmed, Ali Yasen Y.</creatorcontrib><creatorcontrib>Zaman, Shafquat</creatorcontrib><creatorcontrib>Peravali, Rajeev</creatorcontrib><title>Simultaneous versus staged colorectal and hepatic resections for colorectal cancer with synchronous hepatic metastases: a meta-analysis of outcomes and clinical characteristics</title><title>International journal of colorectal disease</title><addtitle>Int J Colorectal Dis</addtitle><description>Objectives
To evaluate the comparative outcomes and clinical characteristics of simultaneous and staged colorectal and hepatic resections for colorectal cancer with synchronous hepatic metastases.
Methods
We conducted a systematic search of electronic information sources, and bibliographic reference lists. Perioperative morbidity and mortality, anastomotic leak, wound infection, bile leak, bleeding, intra-abdominal abscess, sub-phrenic abscess, reoperation, recurrence, 5-year overall survival, procedure time, and length of hospital stay were the evaluated outcome parameters. Combined overall effect sizes were calculated using random-effects model.
Results
We identified 41 comparative studies reporting a total of 12,081 patients who underwent simultaneous (
n
= 5013) or staged (
n
= 7068) resections for colorectal cancer with synchronous hepatic metastases. There were significantly lower use of neoadjuvant chemotherapy (
p
= 0.003), higher right-sided colonic resections (
p
< 0.00001), and minor hepatic resections (
p
< 0.00001) in the simultaneous group. The simultaneous resection was associated with significantly lower rate of bleeding (OR 0.60,
p
= 0.03) and shorter length of hospital stay (MD − 5.40,
p
< 0.00001) compared to the staged resection. However, no significant difference was found in perioperative morbidity (OR1.04,
p
= 0.63), mortality (RD 0.00,
p
= 0.19), anastomotic leak (RD 0.01,
p
= 0.33), bile leak (OR 0.83,
p
= 0.50), wound infection (OR 1.17,
p
= 0.19), intra-abdominal abscess (RD 0.01,
p
= 0.26), sub-phrenic abscess (OR 1.26,
p
= 0.48), reoperation (OR 1.32,
p
= 0.18), recurrence (OR 1.33,
p
= 0.10), 5-year overall survival (OR 0.88,
p
= 0.19), or procedure time (MD − 23.64,
p
= 041) between two groups.
Conclusions
Despite demonstrating nearly comparable outcomes, the best available evidence (level 2) regarding simultaneous and staged colorectal and hepatic resections for colorectal cancer with synchronous hepatic metastases is associated with major selection bias. It is time to conduct high-quality randomised studies with respect to burden and laterality of disease. We recommend the staged approach for complex cases.</description><subject>Abscesses</subject><subject>Anastomotic leak</subject><subject>Bile</subject><subject>Bleeding</subject><subject>Cancer</subject><subject>Chemotherapy</subject><subject>Colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>Comparative analysis</subject><subject>Gastroenterology</subject><subject>Health aspects</subject><subject>Hepatology</subject><subject>Infection</subject><subject>Internal Medicine</subject><subject>Liver</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Meta-analysis</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Proctology</subject><subject>Review</subject><subject>Surgery</subject><subject>Survival</subject><subject>Wound infection</subject><issn>0179-1958</issn><issn>1432-1262</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9ks-KFDEQxhtRcBx9AU8BL156N0mn02lvy-I_WPCgnkOZqZ7J0p2MqbQyb7WPaHpaWRWRHIoqft-XVPiq6rngF4Lz7pI4b4yqueQ1b3Sv6v5BtRGqkbWQWj6sNlx0fS361jyunhDd8tLrTm2qu49-mscMAeNM7BsmKoUy7HHHXBxjQpdhZBB27IBHyN6xhFSGPgZiQ0y_Uw6Cw8S--3xgdArukGJYbH8pJ8xQvAnpFYNzV0OA8USeWBxYnLOLE9L5Njf64N1ieoAELmPyVDzoafVogJHw2c-6rT6_ef3p-l198-Ht--urm9op0ee6VwYG3sOOCz4MstOtEOCEQKm06YwBBz036GSjBgNK9lxz2QktvgjBW9U22-rl6ntM8euMlO3kyeE4rl9lpZJNK3TTmYK--Au9jXMqiy1UIzTvpG7uqT2MaH0YYi57Lab2qhNKmU4Xu2118Q-qnB1O3sWAgy_zPwRyFbgUiRIO9pj8BOlkBbdLNuyaDVuyYc_ZsH0RNauIChz2mO5f_B_VDwgcvlA</recordid><startdate>20200901</startdate><enddate>20200901</enddate><creator>Hajibandeh, Shahin</creator><creator>Hajibandeh, Shahab</creator><creator>Sultana, Abida</creator><creator>Ferris, Gabriella</creator><creator>Mwendwa, Josiah</creator><creator>Mohamedahmed, Ali Yasen Y.</creator><creator>Zaman, Shafquat</creator><creator>Peravali, Rajeev</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6159-1068</orcidid></search><sort><creationdate>20200901</creationdate><title>Simultaneous versus staged colorectal and hepatic resections for colorectal cancer with synchronous hepatic metastases: a meta-analysis of outcomes and clinical characteristics</title><author>Hajibandeh, Shahin ; Hajibandeh, Shahab ; Sultana, Abida ; Ferris, Gabriella ; Mwendwa, Josiah ; Mohamedahmed, Ali Yasen Y. ; Zaman, Shafquat ; Peravali, Rajeev</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c419t-948af09ad010ff276511ac11e2468788aca908ec234f8a42906027161b1105453</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Abscesses</topic><topic>Anastomotic leak</topic><topic>Bile</topic><topic>Bleeding</topic><topic>Cancer</topic><topic>Chemotherapy</topic><topic>Colorectal cancer</topic><topic>Colorectal carcinoma</topic><topic>Comparative analysis</topic><topic>Gastroenterology</topic><topic>Health aspects</topic><topic>Hepatology</topic><topic>Infection</topic><topic>Internal Medicine</topic><topic>Liver</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Meta-analysis</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Proctology</topic><topic>Review</topic><topic>Surgery</topic><topic>Survival</topic><topic>Wound infection</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hajibandeh, Shahin</creatorcontrib><creatorcontrib>Hajibandeh, Shahab</creatorcontrib><creatorcontrib>Sultana, Abida</creatorcontrib><creatorcontrib>Ferris, Gabriella</creatorcontrib><creatorcontrib>Mwendwa, Josiah</creatorcontrib><creatorcontrib>Mohamedahmed, Ali Yasen Y.</creatorcontrib><creatorcontrib>Zaman, Shafquat</creatorcontrib><creatorcontrib>Peravali, Rajeev</creatorcontrib><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hajibandeh, Shahin</au><au>Hajibandeh, Shahab</au><au>Sultana, Abida</au><au>Ferris, Gabriella</au><au>Mwendwa, Josiah</au><au>Mohamedahmed, Ali Yasen Y.</au><au>Zaman, Shafquat</au><au>Peravali, Rajeev</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Simultaneous versus staged colorectal and hepatic resections for colorectal cancer with synchronous hepatic metastases: a meta-analysis of outcomes and clinical characteristics</atitle><jtitle>International journal of colorectal disease</jtitle><stitle>Int J Colorectal Dis</stitle><date>2020-09-01</date><risdate>2020</risdate><volume>35</volume><issue>9</issue><spage>1629</spage><epage>1650</epage><pages>1629-1650</pages><issn>0179-1958</issn><eissn>1432-1262</eissn><abstract>Objectives
To evaluate the comparative outcomes and clinical characteristics of simultaneous and staged colorectal and hepatic resections for colorectal cancer with synchronous hepatic metastases.
Methods
We conducted a systematic search of electronic information sources, and bibliographic reference lists. Perioperative morbidity and mortality, anastomotic leak, wound infection, bile leak, bleeding, intra-abdominal abscess, sub-phrenic abscess, reoperation, recurrence, 5-year overall survival, procedure time, and length of hospital stay were the evaluated outcome parameters. Combined overall effect sizes were calculated using random-effects model.
Results
We identified 41 comparative studies reporting a total of 12,081 patients who underwent simultaneous (
n
= 5013) or staged (
n
= 7068) resections for colorectal cancer with synchronous hepatic metastases. There were significantly lower use of neoadjuvant chemotherapy (
p
= 0.003), higher right-sided colonic resections (
p
< 0.00001), and minor hepatic resections (
p
< 0.00001) in the simultaneous group. The simultaneous resection was associated with significantly lower rate of bleeding (OR 0.60,
p
= 0.03) and shorter length of hospital stay (MD − 5.40,
p
< 0.00001) compared to the staged resection. However, no significant difference was found in perioperative morbidity (OR1.04,
p
= 0.63), mortality (RD 0.00,
p
= 0.19), anastomotic leak (RD 0.01,
p
= 0.33), bile leak (OR 0.83,
p
= 0.50), wound infection (OR 1.17,
p
= 0.19), intra-abdominal abscess (RD 0.01,
p
= 0.26), sub-phrenic abscess (OR 1.26,
p
= 0.48), reoperation (OR 1.32,
p
= 0.18), recurrence (OR 1.33,
p
= 0.10), 5-year overall survival (OR 0.88,
p
= 0.19), or procedure time (MD − 23.64,
p
= 041) between two groups.
Conclusions
Despite demonstrating nearly comparable outcomes, the best available evidence (level 2) regarding simultaneous and staged colorectal and hepatic resections for colorectal cancer with synchronous hepatic metastases is associated with major selection bias. It is time to conduct high-quality randomised studies with respect to burden and laterality of disease. We recommend the staged approach for complex cases.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><doi>10.1007/s00384-020-03694-9</doi><tpages>22</tpages><orcidid>https://orcid.org/0000-0001-6159-1068</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0179-1958 |
| ispartof | International journal of colorectal disease, 2020-09, Vol.35 (9), p.1629-1650 |
| issn | 0179-1958 1432-1262 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2423516378 |
| source | SpringerLink Journals - AutoHoldings |
| subjects | Abscesses Anastomotic leak Bile Bleeding Cancer Chemotherapy Colorectal cancer Colorectal carcinoma Comparative analysis Gastroenterology Health aspects Hepatology Infection Internal Medicine Liver Medical research Medicine Medicine & Public Health Medicine, Experimental Meta-analysis Metastases Metastasis Morbidity Mortality Proctology Review Surgery Survival Wound infection |
| title | Simultaneous versus staged colorectal and hepatic resections for colorectal cancer with synchronous hepatic metastases: a meta-analysis of outcomes and clinical characteristics |
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