Single-center retrospective study of simultaneous resection in patients with high-risk synchronous rectal cancer liver metastases

Simultaneous rectal and hepatic resection for metastatic rectal cancer is not commonly performed due to concers about safety. A retrospective study at City of Hope National Medical Center (Duarte, CA) evaluated peri-operative and oncological outcomes for patients with rectal cancer liver metastases (RCLM) after simultaneous resection. The study included 92 patients who underwent curative-intent, simultaneous total mesorectal excision and hepatectomy for RCLM (January 2011 to May 2024). The majority of patients had high burden of hepatic metastases. No patients died. Fourteen patients (15%) had Clavien-Dindo > 3 complication eight(95) drainage of perihepatic fluid, and three (3%) anastomotic dehiscence. Median follow-up was 51 months, median overall survival was 70 months, and median recurrence-free survival was 10 months.The authors conclude that simultaneous resection of RCLM was associated with peri-operative safety and long-term survival in RCLM patients with high-risk disease.