Optimal surgical sequence for colorectal cancer liver metastases patients receiving colorectal cancer resection with simultaneous liver metastasis resection: A multicentre retrospective propensity score matching study

作者：Qichen Chen, Rui Zhang, Baocai Xing, Cong Li, Dianrong Xiu, Jinghua Chen, Yiqiao Deng, Xiao Chen, Rui Guo, Fenglin Chen, Jianhong Peng, Tao Sun, Hangyan Wang, Muxing Li, Qiwen Zheng, Xinyu Bi, Jianjun Zhao, Jianguo Zhou, Zhiyu Li, Zhen Huang, Yefan Zhang, Yizhou Zhang, Jianqiang Cai, Hong Zhao · 发表于：International Journal of Surgery · 年份：2022 · DOI：10.1016/j.ijsu.2022.106952 · 被引用次数：8 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Intraperitoneal and Appendiceal Malignancies、Colorectal Cancer Surgical Treatments

BACKGROUND: There is little evidence regarding the optimal surgical sequence for colorectal cancer liver metastasis (CRLM) patients undergoing colorectal resection with simultaneous liver metastasis resection. METHODS: CRLM patients from five centers were retrospectively evaluated. The short-term outcomes included intraoperative and postoperative outcomes. Postoperative complications were measured according to the Clavien-Dindo classification. Grade I to II complications were defined as minor postoperative complications. The long-term outcomes were progression-free survival (PFS) and overall survival (OS). Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were performed to overcome the selection bias between colorectal resection first and liver resection first. RESULTS: , primary site in the left hemicolon, non-bilobar distribution of liver metastases and no preoperative chemotherapy were significantly associated with the likelihood of colorectal resection first. After 1:1 PSM, there was no significant difference between the colorectal resection first group and the liver resection first group. Compared with patients with colorectal resection first, patients with liver resection first had a comparable postoperative infection rate (15.0% vs. 16.0%, P = 0.735), a longer operation time (305.0 [231.3-416.0] vs. 300.0 [225.0-374.0], P = 0.033), more intraoperative blood loss (200.0 [150.0-400.0] vs. 100.0 [100.0-300.0], P < 0.001), a higher posto...