关键词: Multi-institutional study Simultaneous resection Staged resection Synchronous colorectal liver metastases Win ratio

Mesh : Humans Colorectal Neoplasms / surgery pathology Hepatectomy / adverse effects Liver Neoplasms / secondary Databases, Factual Treatment Outcome Retrospective Studies

来  源:   DOI:10.1016/j.amjsurg.2022.11.015

Abstract:
In order to investigate the optimal approach for synchronous colorectal liver metastases (sCRLM), we sought to use the \"win ratio\" (WR), a novel statistical approach, to assess the relative benefit of simultaneous versus staged surgical treatment.
Patients who underwent hepatectomy for sCRLM between 2008 and 2020 were identified from a multi-institutional database. The WR approach was utilized to compare composite outcomes of patients undergoing simultaneous versus staged resection.
Among 1116 patients, 642 (57.5%) presented with sCRLM; 290 (45.2%) underwent simultaneous resection, while 352 (54.8%) underwent staged resection. In assessing the composite outcome, staged resection yielded a WR of 1.59 (95%CI 1.47-1.71) over the simultaneous approach for sCRLM. The highest WR occurred among patients requiring major hepatectomy (WR = 1.93, 95%CI 1.77-2.10) compared with patients who required minor liver resection (WR = 1.55, 95%CI 1.44-1.70).
Staged resection was superior to simultaneous resection for sCRLM based on a WR assessment.
摘要:
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