Synchronous Rectal and Hepatic Resection of Rectal Metastatic Disease

Sarah York Boostrom, Liana Tsikitis Vassiliki, David M. Nagorney, Bruce G. Wolff, Heidi K. Chua, Scott Harmsen, David Larson

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: The objectives were to determine the feasibility of combined rectal and hepatic resections and analyze the disease-free survival and overall survival. Study Design: Sixty patients who underwent resection for metastatic rectal disease from 1991 to 2005 at Mayo Clinic were reviewed. Inclusion criteria were: rectal cancer with metastatic liver disease and resectability of metastases. The exclusion criteria were: metachronous resection (n = 15). Kaplan-Meier Survival estimated overall survival (OS) and disease-free survival (DFS). Cox proportional hazard models examined the association between groups and survival. Results: The cohort comprised 22 men and 23 women, with median age of 63 years. Surgical management included: abdominoperineal resection, 13 patients (29%); low anterior resection, 29 (64%); local excision, one; total proctocolectomy, one; and pelvic exenteration, one. Major hepatic resection was performed in 22%. There was no mortality, but there were 26 postoperative complications. Disease-free survival from local recurrence at 1, 2, and 5 years was 92%, 86%, and 80%, respectively. Disease-free survival from distant recurrence at 1, 2, and 5 years was 62%, 43%, and 28%, respectively. Overall survival at 1, 2 and 5 years was 88%, 72%, and 32%, respectively. Conclusions: Combined rectal and hepatic resection is safe. Morbidity and mortality do not preclude concurrent resection. The DFS and OS are comparable to that of patients undergoing a staged procedure.

Original languageEnglish (US)
Pages (from-to)1583-1588
Number of pages6
JournalJournal of Gastrointestinal Surgery
Volume15
Issue number9
DOIs
StatePublished - Sep 2011

Fingerprint

Rectal Diseases
Disease-Free Survival
Survival
Liver
Pelvic Exenteration
Recurrence
Mortality
Rectal Neoplasms
Proportional Hazards Models
Liver Diseases
Neoplasm Metastasis
Morbidity

Keywords

  • Hepatic
  • Metastatic
  • Rectal
  • Synchronous

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Boostrom, S. Y., Vassiliki, L. T., Nagorney, D. M., Wolff, B. G., Chua, H. K., Harmsen, S., & Larson, D. (2011). Synchronous Rectal and Hepatic Resection of Rectal Metastatic Disease. Journal of Gastrointestinal Surgery, 15(9), 1583-1588. https://doi.org/10.1007/s11605-011-1604-9

Synchronous Rectal and Hepatic Resection of Rectal Metastatic Disease. / Boostrom, Sarah York; Vassiliki, Liana Tsikitis; Nagorney, David M.; Wolff, Bruce G.; Chua, Heidi K.; Harmsen, Scott; Larson, David.

In: Journal of Gastrointestinal Surgery, Vol. 15, No. 9, 09.2011, p. 1583-1588.

Research output: Contribution to journalArticle

Boostrom, SY, Vassiliki, LT, Nagorney, DM, Wolff, BG, Chua, HK, Harmsen, S & Larson, D 2011, 'Synchronous Rectal and Hepatic Resection of Rectal Metastatic Disease', Journal of Gastrointestinal Surgery, vol. 15, no. 9, pp. 1583-1588. https://doi.org/10.1007/s11605-011-1604-9
Boostrom SY, Vassiliki LT, Nagorney DM, Wolff BG, Chua HK, Harmsen S et al. Synchronous Rectal and Hepatic Resection of Rectal Metastatic Disease. Journal of Gastrointestinal Surgery. 2011 Sep;15(9):1583-1588. https://doi.org/10.1007/s11605-011-1604-9
Boostrom, Sarah York ; Vassiliki, Liana Tsikitis ; Nagorney, David M. ; Wolff, Bruce G. ; Chua, Heidi K. ; Harmsen, Scott ; Larson, David. / Synchronous Rectal and Hepatic Resection of Rectal Metastatic Disease. In: Journal of Gastrointestinal Surgery. 2011 ; Vol. 15, No. 9. pp. 1583-1588.
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