Delaying surgery beyond six weeks after systemic therapy reduces postoperative morbidity without evidence of impaired oncologic outcomes in colorectal liver metastases - Summary - MDSpire
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Delaying surgery beyond six weeks after systemic therapy reduces postoperative morbidity without evidence of impaired oncologic outcomes in colorectal liver metastases
To evaluate the impact of time-to-surgery (TTS) on postoperative morbidity and oncologic outcomes following surgery for colorectal liver metastases (CRLM) after neoadjuvant systemic therapy (NAT).
Approach:
Study Design: A retrospective cohort study of 159 patients who underwent oncologic resection of CRLM following NAT at Heidelberg University Hospital.
Participants: Included adult patients with histologically confirmed synchronous or metachronous CRLM who received NAT prior to surgery.
Variables: Primary exposure was TTS, analyzed continuously and categorized at various intervals (≥ 35, 42, 49, 56 days).
Outcomes: Primary outcome was postoperative morbidity (CCI > 30), secondary outcomes included liver-specific recurrence-free survival (RFS) and overall survival (OS).
Statistical Methods: Used logistic regression for morbidity and Cox models for survival, with adjustments for confounding variables.
Key Findings:
Postponing surgery beyond six weeks after NAT was associated with lower postoperative complications.
No significant compromise on oncological outcomes was observed with delayed surgery.
Interpretation:
Delaying surgery after NAT may reduce postoperative complications without negatively impacting long-term oncological outcomes in patients with CRLM.
Limitations:
Retrospective design may introduce selection bias.
Findings are based on a single institution, limiting generalizability.
Conclusion:
Postponing surgery beyond six weeks after NAT may reduce postoperative complications in patients with CRLM.
by Esther Giehl-Brown, Rajan Nikbakhsh, Ana Mansourkiaei, Laila Jötten, Bruno Christian Köhler, Thomas Longerich, Bo Kong, Arianeb Mehrabi, Markus W Büchler, Mohammed Al-Saeedi, Christoph Kahlert
