Abstract
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Colorectal Disease |
| Vol/bind | 11 |
| Udgave nummer | 1 |
| Sider (fra-til) | 3-10 |
| Antal sider | 7 |
| ISSN | 1462-8910 |
| DOI | |
| Status | Udgivet - 2008 |
Bibliografisk note
Keywords: Age Factors; Colectomy; Colorectal Neoplasms; Evidence-Based Medicine; Hepatectomy; Humans; Length of Stay; Liver Neoplasms; Survival AnalysisAdgang til dokumentet
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I: Colorectal Disease, Bind 11, Nr. 1, 2008, s. 3-10.
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review
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TY - JOUR
T1 - Staged or simultaneous resection of synchronous liver metastases from colorectal cancer--a systematic review
AU - Hillingsø, J G
AU - Wille-Jørgensen, P
N1 - Keywords: Age Factors; Colectomy; Colorectal Neoplasms; Evidence-Based Medicine; Hepatectomy; Humans; Length of Stay; Liver Neoplasms; Survival Analysis
PY - 2008
Y1 - 2008
N2 - OBJECTIVE: A systematic review of the literature was undertaken to estimate the differences in length of hospital stay, morbidity, mortality and long-term survival between staged and simultaneous resection of synchronous liver metastases from colorectal cancer to determine the level of evidence for recommendations of a treatment strategy. METHOD: A Pub-med search was undertaken for studies comparing patients with synchronous liver metastases, who either had a combined or staged resection of metastases. Twenty-six were considered and 16 were included based on Newcastle Ottawa Quality Assessment Scale. All studies were retrospective and had a general bias, because the staged procedure was significantly more often undertaken in patients with left-sided primary tumours and larger, more numerous and bi-lobar metastases. Analyses of primary outcomes were performed using the random effects model. RESULTS: For the reason of the heterogeneity of the observational studies, no odds ratios were calculated. In 11 studies, there was a tendency towards a shorter hospital stay in the synchronous resection group. Fourteen studies compared total perioperative morbidity and lower morbidity was observed in favour of a combined resection. Fifteen studies compared perioperative mortality, which seemed to be lower with the staged approach. Eleven studies compared 5-year survival, which seemed to be similar in the two groups. CONCLUSION: No randomized controlled trials were identified, and hence a meta-analysis was not performed. The evidence level is II to III with grade C recommendations. Synchronous resections can be undertaken in selected patients, provided that surgeons specialized in colorectal and hepatobiliary surgery are available.
AB - OBJECTIVE: A systematic review of the literature was undertaken to estimate the differences in length of hospital stay, morbidity, mortality and long-term survival between staged and simultaneous resection of synchronous liver metastases from colorectal cancer to determine the level of evidence for recommendations of a treatment strategy. METHOD: A Pub-med search was undertaken for studies comparing patients with synchronous liver metastases, who either had a combined or staged resection of metastases. Twenty-six were considered and 16 were included based on Newcastle Ottawa Quality Assessment Scale. All studies were retrospective and had a general bias, because the staged procedure was significantly more often undertaken in patients with left-sided primary tumours and larger, more numerous and bi-lobar metastases. Analyses of primary outcomes were performed using the random effects model. RESULTS: For the reason of the heterogeneity of the observational studies, no odds ratios were calculated. In 11 studies, there was a tendency towards a shorter hospital stay in the synchronous resection group. Fourteen studies compared total perioperative morbidity and lower morbidity was observed in favour of a combined resection. Fifteen studies compared perioperative mortality, which seemed to be lower with the staged approach. Eleven studies compared 5-year survival, which seemed to be similar in the two groups. CONCLUSION: No randomized controlled trials were identified, and hence a meta-analysis was not performed. The evidence level is II to III with grade C recommendations. Synchronous resections can be undertaken in selected patients, provided that surgeons specialized in colorectal and hepatobiliary surgery are available.
U2 - 10.1111/j.1463-1318.2008.01625.x
DO - 10.1111/j.1463-1318.2008.01625.x
M3 - Journal article
C2 - 18637099
SN - 1462-8910
VL - 11
SP - 3
EP - 10
JO - Colorectal Disease
JF - Colorectal Disease
IS - 1
ER -