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<p>Liver first approach is one of the possible strategies for synchronous CRLM. Less attention is generally reserved to colorectal resection after hepatic surgery. Aim of the study is to investigate the influence of liver resection on primary tumor surgery. In the present monocentric cohort study, patients operated onlaparoscopic CR resection after open or laparoscopic liver surgery are compared (propensity score matching analysis 1:3) with laparoscopically operated non metastatic CR patients in period 2015–2023. Primary endpoint: 30 day morbidity; secondary endpoints: conversion, reintervention and 90 days mortality rate, surgery duration. Forty liver-first and 642 control patients are matched; 40 and 120 patients respectively are compared after matching. Morbidity rate 32.5% and 37.5% (<i>p</i> = 0.568); CCI 100 &gt;20.9 4/40 and 21/120 (<i>p</i> = 0.257); conversion rate 7.5% and 10% (<i>p</i> = 0.638); reintervention 3/40 and 13/120 (<i>p</i> = 0.761); mortality 0/40 and 1/120; surgery duration 288 and 279 min (<i>p</i> = 0.650). No difference in hospital stay (6.5 and 7 days in liver first and control group respectively). Liver-first approach does not worsten intraoperative and post-operative short term outcomes of primary tumor resection.</p>

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The impact of liver-first approach on primary cancer surgery in patients with syncronous colorectal liver metastases

  • 期刊论文

  • 发表日期：

    2026年6月22日

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  • Federica Gonella,
  • Roberto Lo Tesoriere,
  • Marco Palisi,
  • Filippo Pepe,
  • Paolo Massucco,
  • Alessandro Ferrero

摘要

Liver first approach is one of the possible strategies for synchronous CRLM. Less attention is generally reserved to colorectal resection after hepatic surgery. Aim of the study is to investigate the influence of liver resection on primary tumor surgery. In the present monocentric cohort study, patients operated onlaparoscopic CR resection after open or laparoscopic liver surgery are compared (propensity score matching analysis 1:3) with laparoscopically operated non metastatic CR patients in period 2015–2023. Primary endpoint: 30 day morbidity; secondary endpoints: conversion, reintervention and 90 days mortality rate, surgery duration. Forty liver-first and 642 control patients are matched; 40 and 120 patients respectively are compared after matching. Morbidity rate 32.5% and 37.5% (p = 0.568); CCI 100 >20.9 4/40 and 21/120 (p = 0.257); conversion rate 7.5% and 10% (p = 0.638); reintervention 3/40 and 13/120 (p = 0.761); mortality 0/40 and 1/120; surgery duration 288 and 279 min (p = 0.650). No difference in hospital stay (6.5 and 7 days in liver first and control group respectively). Liver-first approach does not worsten intraoperative and post-operative short term outcomes of primary tumor resection.