801 Simultaneous Resection for Metastatic Colorectal Cancer – What Should We Tell Our Patients to Expect?

Aim Almost half of colorectal patients will advance to liver metastasis during the course of their disease. The aim of the present study was to evaluate outcomes across different treatment arms in patients undergoing synchronous resection of primary colorectal cancer and liver metastases. Method 2-year retrospective review of all patients receiving simultaneous resection of primary bowel cancer and secondary liver metastases at a single tertiary hepatobiliary unit, from a prospective operative database. Patients were stratified by extent of liver resection (major, >3 segments or minor < 3) and by bowel (rectal or colon) surgery performed. Primary outcomes were rate of complications within 30 days following surgery and length of stay (LOS) in hospital. Secondary outcomes were blood loss, pringle time, time spent in theatre and interval between first outpatient appointment and surgery. Results A total of 44 patients were recruited, of these, 38 patients were eligible for inclusion. Complication rates were 67% in the major liver resection and colon surgery group (group 3) and 38% in minor liver resection and rectal surgery group (group 2). Group 3 had the longest mean LOS (17.2 days) in comparison to group 2 (9.2 days). Major and minor hepatectomies resulted in a mean blood loss of 720ml and 445ml respectively. Conclusions Synchronous resections involving major hepatectomies are associated with a higher rate of post-operative and peri-operative complications. While surgery remains the best chance of cure for patients with resectable disease, it is important to set realistic expectations for surgical outcomes.