%0 Journal Article
%T Simultaneous versus staged resection for synchronous colorectal liver metastases: The win ratio approach.
%A Endo Y
%A Alaimo L
%A Araujo Lima H
%A Tsilimigras DI
%A Hyer JM
%A Guglielmi A
%A Ruzzenente A
%A Alexandrescu S
%A Poultsides G
%A Sasaki K
%A Aucejo F
%A Pawlik TM
%J Am J Surg
%V 225
%N 3
%D 03 2023
%M 36435656
%F 3.125
%R 10.1016/j.amjsurg.2022.11.015
%X 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.<BR>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.<BR>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).<BR>Staged resection was superior to simultaneous resection for sCRLM based on a WR assessment.