Systematic Review and Meta-Analysis of Resection Sequence in Synchronous Colorectal Liver Metastasis: Primary vs. Liver First.
Sofoklis Mavrantonis, Omar Abou El-Wafa, Sascha Vaghiri et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the outcomes of colorectal first (CRf) versus liver first (Lf) resections in patients with synchronous colorectal liver metastases. Analyzing data from 15 studies involving 8611 patients, the CRf approach showed a significant survival benefit at 1 year and improved disease-free survival (DFS) rates compared to Lf, although no differences were noted in major morbidity or 90-day mortality.
Key findings
- CRf group had a statistically significant 1-year overall survival benefit compared to Lf.
- CRf group demonstrated significantly higher 1-, 3-, and 5-year disease-free survival rates than Lf.
- No significant differences were found in major morbidity or 90-day mortality between the two groups.
Why it matters
Understanding the optimal resection sequence for synchronous colorectal liver metastases is crucial for improving patient outcomes. This analysis provides insights into survival benefits associated with different surgical strategies, informing clinical decision-making.
What to keep in mind
The findings are based on observational studies, and there is a lack of randomized control trials to support the conclusions.