Surgical treatment of rectal cancer with synchronous liver metastasis

Summary. Comparative analysis of treatment outcomes of 41 patients with metastatic rectal cancer with synchronous liver affection (sM-RC), who underwent surgical interventions in the clinic of the National Institute of Cancer from November 2008 to September 2013 was provided. The patients were rando­mized into the groups of combined (group I — resection of primary tumor and distant metastases simultaneously) and staged (group II — resection of primary tumor and distant metastases in two stages) surgical treatment. Obtained results analysis did not demonstrate statistically reliable difference in the level of early post-surgical complications in study groups according to Clavien — Dindo scale (Grade II; IIIa; IIIb; IVa) that was 4.7; 14.3; 9.5; 4.7 and 10; 10; 5; 0%, respectively, in the groups I and II. No post-surgical lethality was registered in the groups. The most serious complications (Clavien — Dindo Grades IIIb, IVa) were reported in patients of group I that underwent excision of more than 40% of liver parenchyma (hemihepatectomy + segment/section). In 3 patients (14.3%) of the group I partial colonic anastomotic leak developed in early post-surgical period; this was not registered in the group II (р=0.21). In staged resections group (group II) total cumulative 3-year survival was 40.0%, while at combined surgical approach (group I) this characteristic was reliably higher — 61.9% (р