Global survey on the surgical management of patients affected by colorectal cancer with synchronous liver metastases: impact of surgical specialty and geographic region

• DOI: 10.1007/s00464-023-09917-8
• Publication Date: 2023-03-06T18:02:25Z
• Authors: Jasper Paul Sijbe...; Antonino Spinelli; Alessandro Ferrero; Manish Chand; Steven Wexner; Marc G. Besselink; Ibrahim Dagher; Giuseppe Zimmitti; Burak Görgec; Antonio de Lacy; Mayank Roy; Pieter Tanis; Carlo Tonti; Mohammed Abu Hilal
• Keywords: Colorectal Surgery; Specialty

Consensus on the best surgical strategy for management of synchronous colorectal liver metastases (sCRLM) has not been achieved. This study aimed to assess attitudes surgeons involved in treatment sCRLM.Surveys designed colorectal, hepato-pancreato-biliary (HPB), and general were disseminated through representative societies. Subgroup analyses performed compare responses between specialties continents.Overall, 270 (57 100 HPB 113 surgeons) responded. Specialist more frequently utilized minimally invasive surgery (MIS) than colon (94.8% vs. 71.7%, p < 0.001), rectal (91.2% 64.6%, resections (53% 34.5%, = 0.005). In patients with an asymptomatic primary, liver-first two-stage approach was preferred most respondents' centres (59.3%), while colorectal-first Oceania (83.3%) Asia (63.4%). A substantial proportion respondents (72.6%) had personal experience simultaneous resections, expanding role this procedure foreseen (92.6%), evidence desired (89.6%). Respondents reluctant combine a hepatectomy low anterior (76.3%) abdominoperineal (73.3%), compared right (94.4%) left hemicolectomies (90.7%). Colorectal less inclined or major (right: 22.8% 50% 44.2%, 0.008; left: 14% 34% 35.4%, 0.002, respectively).The clinical practices viewpoints sCRLM differ continents, within specialties. However, there appears be consensus growing MIS need evidence-based input.