Optimizing clinical and economic outcomes of surgical therapy for patients with colorectal cancer and synchronous liver metastases.

Journal of the American College of Surgeons
Daniel E AbbottGeorge J Chang

Abstract

Traditionally, for patients with colorectal cancer with resectable synchronous liver metastases, resections were performed separately. However, the safety and efficacy of simultaneous resection have been demonstrated in selected patients. The purpose of this study was to evaluate outcomes and economic implications of simultaneous and staged resections. We conducted a retrospective cohort study of consecutive colorectal cancer patients with resectable synchronous liver metastases treated between 1993 and 2010, constructing a decision tree comparing simultaneous and staged resections. For generalizability, the analysis was conducted from a payer perspective, using costs derived from 2010 Medicare reimbursement. Decision models incorporated the severity-refined DRG complications (complicating condition/major complicating condition) modifiers. Sensitivity analyses used alternative models of DRG reimbursement. There were 144 patients analyzed. Sixty (41.7%) underwent simultaneous resection and 84 (58.3%) underwent staged resection. Median overall survival did not differ between the simultaneous and the staged cohorts (66.3 vs 65.6 months, respectively), nor did the overall complication rate (38.3% vs 40.5%, respectively). Median tot...Continue Reading

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Citations

Feb 14, 2013·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Kentaro NakajimaYuichiro Kato
Jan 15, 2014·International Journal of Colorectal Disease·Shaun P McKenzieDaniel L Davenport
Jun 27, 2014·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Aslam EjazTimothy M Pawlik
Sep 17, 2013·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Ching-Wei D TzengThomas A Aloia
Mar 21, 2013·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Vincent W T LamArthur J Richardson
Jun 14, 2016·BioMed Research International·Stefano GarritanoMarcello Giuseppe Spampinato
May 28, 2013·World Journal of Gastrointestinal Surgery·Fausto MeriggiAlberto Zaniboni
Sep 24, 2015·American Journal of Clinical Oncology·Veena ShankaranTanya G K Bentley
Sep 20, 2017·Minimally Invasive Therapy & Allied Technologies : MITAT : Official Journal of the Society for Minimally Invasive Therapy·Xiao XuGuanglong Dong
Nov 28, 2018·Journal of Surgical Oncology·Dimitrios MorisTimothy M Pawlik
Mar 1, 2019·Journal of Surgical Oncology·Robert W Krell, Michael I D'Angelica
Jun 14, 2019·Annals of Surgical Oncology·James R Barrett, Daniel E Abbott
Feb 23, 2017·Annals of Surgical Oncology·Shahzad M AliDavid W Larson
Oct 27, 2018·World Journal of Gastrointestinal Oncology·Emilio De RaffeleFrancesco Minni
Aug 11, 2020·Minerva chirurgica·Leticia Pérez-SantiagoLuis Sabater
Mar 18, 2020·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·Mohammad GhiaslooWim Ceelen
Oct 31, 2021·Annals of Surgical Oncology·Anthony K C ChanUNKNOWN CoSMIC Collaborators

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