SIMULTANEOUS SURGICAL TREATMENT OF PATIENTS WITH COLORECTAL CANCER AND LIVER METASTASIS.

Aim of study - to analyze initial single center experience in simultaneous surgical approach of patients with CRCLM, their Overall Survival (OS) and Disease-Free Survival (DFS). Overall 14 patients (9 male and 5 female) with CRC and LM were included in this study who underwent radical simultaneous colorectal and liver resection.Parenchymal-sparing hepatectomy (PSH) was performed in 13 (92,9%) patients versus anatomical resection (left hemihepatectomy) only in 1 (7,1%) patient. During retrospective analysis of OS and DFS we divided patients in two subgroups: site of primary tumor and lymph node status. There were no significant postoperative complications and 30-day mortality. Median OS and DFS of patients with right side colon cancer was 17,3 (p=0,003) and 9,2 months (p=0,26) respectively. Median OS and DFS of patients with N+ status was 24,3±4,8 (p=0,003) and 13 months (p=0,0004) respectively (all patients have already died, range 4 - 44 months). All patients with N0 status are still alive with no sign of disease recurrence. The longest period of DFS is approximately 80 months which is still observing in 3 patients (range of observation 11 - 80 months). Simultaneous colon resection and PSH is aggressive, excusable and cost effective surgical approach in radical treatment of CRCLM which does not compromise oncological outcomes. There was no evidence of increasing of complication rate. The group of patients with right sided colon cancer and those with N+ status had significant worse prognosis with poor OS and DFS.