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Colletti G, Ciniselli CM, Sorrentino L, Bagatin C, Verderio P, Cosimelli M. Multimodal treatment of rectal cancer with resectable synchronous liver metastases: A systematic review. Dig Liver Dis 2023; 55:1602-1610. [PMID: 37277288 DOI: 10.1016/j.dld.2023.05.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/22/2023] [Accepted: 05/23/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND Specific studies on stage IV rectal cancer are lacking. The aim of this study is to describe the current status of rectum-first approach (RFA), liver-first approach (LFA) and simultaneous approach (SA) in these patients. METHODS A systematic review was performed on PubMed, EMBASE and Cochrane including studies published from January 2005 to January 2021. Studies on colon cancer only, colon and rectal cancer without distinction, extrahepatic metastases at diagnosis, or case reports/letters were excluded. Main outcomes were 5-yr overall survival (OS) and treatment completion rates. RESULTS 22 studies were included for a total of 1,653 patients. 77% of the studies were retrospective and mainly (59%) reported one treatment approach. The primary endpoint was declared in 27% of the studies. Irrespective of treatment approaches, the 5-yr OS rate was reported in 72% of the studies. The 5-yr OS rates ranged from 38.5% to 75% for LFA, from 28% and 80% for RFA and from 28.2% to 77.3% for SA. Treatment completion rates ranged from 50% to 100% for LFA, from 37% to 100% for RFA, and from 66% to 100% for SA. CONCLUSION The wide heterogeneity of the results reflects that the therapeutic strategy in this setting is a case-by-case multidisciplinary decision and depends on several patient-specific features.
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Affiliation(s)
- Gaia Colletti
- Colorectal Surgery Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133, Milan, Italy
| | - Chiara Maura Ciniselli
- Bioinformatics and Biostatistics Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133, Milan, Italy
| | - Luca Sorrentino
- Colorectal Surgery Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133, Milan, Italy.
| | - Clara Bagatin
- Bioinformatics and Biostatistics Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133, Milan, Italy
| | - Paolo Verderio
- Bioinformatics and Biostatistics Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133, Milan, Italy
| | - Maurizio Cosimelli
- Bioinformatics and Biostatistics Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133, Milan, Italy
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Gumiero JL, Oliveira BMSD, Neto PADO, Pandini RV, Gerbasi LS, Figueiredo MN, Kruger JAP, Seid VE, Araujo SEA, Tustumi F. Timing of resection of synchronous colorectal liver metastasis: A systematic review and meta‐analysis. J Surg Oncol 2022; 126:175-188. [DOI: 10.1002/jso.26868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 03/12/2022] [Indexed: 01/27/2023]
Affiliation(s)
| | | | | | - Rafael Vaz Pandini
- Department of Surgical Oncology Hospital Israelita Albert Einstein São Paulo Brazil
| | - Lucas Soares Gerbasi
- Department of Surgical Oncology Hospital Israelita Albert Einstein São Paulo Brazil
| | | | | | - Victor Edmond Seid
- Department of Surgical Oncology Hospital Israelita Albert Einstein São Paulo Brazil
| | | | - Francisco Tustumi
- Department of Surgical Oncology Hospital Israelita Albert Einstein São Paulo Brazil
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Liu J, Xia Y, Pan X, Yan Z, Zhang L, Yang Z, Wu Y, Xue H, Bai S, Shen F, Wang K. Simultaneous versus staged major hepatectomy (≥3 liver segments) for outcomes of synchronous colorectal liver metastases: A systematic review and meta-analysis. Cancer Rep (Hoboken) 2022; 5:e1617. [PMID: 35753719 PMCID: PMC9351651 DOI: 10.1002/cnr2.1617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 03/02/2022] [Accepted: 03/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background Hepatectomy is an effective treatment for synchronous colorectal liver metastases (SCLM) patients. However, whether to choose simultaneous hepatectomy (SIH) or staged hepatectomy (STH) is still controversial, especially during major hepatectomy (≥3 liver segments). Aims Compare the difference between the SCLM patients underwent SIH and STH, especially during major hepatectomy (≥3 liver segments). Methods and Results A meta‐analysis was conducted by analyzing the published data on the outcomes of SCLM patients underwent SIH or STH from January 2010 to December 2020 from the electronic databases. A random‐effects model was used to derive pooled estimates of odds ratio (OR) with 95% confidence interval (CI) for the explored outcomes. Eventually, 18 studies, including 5101 patients, were included this study. The result of meta‐analysis showed that SIH did not increase postoperative complications (pooled OR: 1.037; 95% CI: 0.897–1.200), perioperative mortality (pooled OR: 0.942; 95% CI: 0.552–1.607), 3‐year mortality (pooled OR: 1.090; 95% CI: 0.903–1.316) or 5‐year mortality (pooled OR: 1.077; 95% CI: 0.926–1.253), as compared with STH. Subgroup analysis showed that, simultaneous major hepatectomy (SIMH) also did not increase postoperative complications (pooled OR: 0.863; 95% CI: 0.627–1.188) or perioperative mortality (pooled OR: 0.689; 95% CI: 0.290–1.637) as compared with staged major hepatectomy (STMH). Conclusion Postoperative complications, perioperative mortality and long‐term prognosis had no significant difference between SIH and STH for SCLM patients. Besides, postoperative complications and perioperative mortality also had no significant difference between SIMH and STMH.
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Affiliation(s)
- Jianwei Liu
- Department of Hepatic Surgery II, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai, China
| | - Yong Xia
- Department of Hepatic Surgery IV, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai, China
| | - Xiaorong Pan
- Shanghai Baoshan District Songnan Town Community Health Center, Shanghai, China
| | - Zhenlin Yan
- Department of Hepatic Surgery IV, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai, China
| | - Lei Zhang
- Department of Hepatic Surgery II, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai, China
| | - Zhao Yang
- Department of Hepatic Surgery II, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai, China
| | - Yeye Wu
- Department of Hepatic Surgery II, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai, China
| | - Hui Xue
- Department of Hepatic Surgery II, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai, China
| | - Shilei Bai
- Department of Hepatic Surgery II, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai, China
| | - Feng Shen
- Department of Hepatic Surgery IV, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai, China
| | - Kui Wang
- Department of Hepatic Surgery II, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai, China
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Opioid-Sparing Analgesia Impacts the Perioperative Anesthetic Management in Major Abdominal Surgery. Medicina (B Aires) 2022; 58:medicina58040487. [PMID: 35454326 PMCID: PMC9029402 DOI: 10.3390/medicina58040487] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/23/2022] [Accepted: 03/26/2022] [Indexed: 12/13/2022] Open
Abstract
Background and Objectives: The management of acute postoperative pain (APP) following major abdominal surgery implies various analgetic strategies. Opioids lie at the core of every analgesia protocol, despite their side effect profile. To limit patients’ exposure to opioids, considerable effort has been made to define new opioid-sparing anesthesia techniques relying on multimodal analgesia. Our study aims to investigate the role of adjuvant multimodal analgesic agents, such as ketamine, lidocaine, and epidural analgesia in perioperative pain control, the incidence of postoperative cognitive dysfunction (POCD), and the incidence of postoperative nausea and vomiting (PONV) after major abdominal surgery. Materials and Methods: This is a clinical, observational, randomized, monocentric study, in which 80 patients were enrolled and divided into three groups: Standard group, C (n = 32), where patients received perioperative opioids combined with a fixed regimen of metamizole/acetaminophen for pain control; co-analgetic group, Co-A (n = 26), where, in addition to standard therapy, patients received perioperative systemic ketamine and lidocaine; and the epidural group, EA (n = 22), which included patients that received standard perioperative analgetic therapy combined with epidural analgesia. We considered the primary outcome, the postoperative pain intensity, assessed by the visual analogue scale (VAS) at 1 h, 6 h, and 12 h postoperatively. The secondary outcomes were the total intraoperative fentanyl dose, total postoperative morphine dose, maximal intraoperative sevoflurane concentration, confusion assessment method for intensive care units score (CAM-ICU) at 1 h, 6 h, and 12 h postoperatively, and the postoperative dose of ondansetron as a marker for postoperative nausea and vomiting (PONV) severity. Results: We observed a significant decrease in VAS score, as the primary outcome, for both multimodal analgesic regimens, as compared to the control. Moreover, the intraoperative fentanyl and postoperative morphine doses were, consequently, reduced. The maximal sevoflurane concentration and POCD were reduced by EA. No differences were observed between groups concerning PONV severity. Conclusions: Multimodal analgesia concepts should be individualized based on the patient’s needs and consent. Efforts should be made to develop strategies that can aid in the reduction of opioid use in a perioperative setting and improve the standard of care.
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Punga D, Isac S, Paraipan C, Cotorogea M, Stefan A, Cobilinschi C, Vacaroiu IA, Tulin R, Ionescu D, Droc G. Impact of COVID-19 Infection on Liver Transplant Recipients: Does It Make Any Difference? Cureus 2022; 14:e22687. [PMID: 35386162 PMCID: PMC8967117 DOI: 10.7759/cureus.22687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2022] [Indexed: 11/25/2022] Open
Abstract
The first case of coronavirus disease 2019 (COVID-19) was diagnosed in December 2019 in Wuhan, China. Since then, this novel infectious disease, caused by the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), has grown into a pandemic with over 330 million infected individuals worldwide, many of them with innate or acquired immunosuppression. Liver transplantation (LT) is offered as a curative therapy for end-stage liver disease as well as for acute liver failure cases. Advances in immunosuppressive therapy decreased the rates of acute and chronic graft rejection, significantly improving the quality of life. Liver transplant recipients are considered at particularly high risk for developing critical COVID-19 infection because of their chronic immunosuppressed state. Available data are heterogeneous, and the mortality rate is variably reported in the literature. There is controversy regarding whether their immunosuppressive status is a risk or a protective factor for developing severe respiratory disease. Moreover, the mechanism of action is still unclear. We report the clinical outcome of three liver transplant recipients who had COVID-19 pneumonia at different moments following liver transplantation. All patients received a standard immunosuppression regimen and specific antiviral therapy, requiring no invasive mechanical ventilation. They were discharged from the hospital with no long-term COVID-19 complications.
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How COVID-19 Pandemics Changed the Treatment Protocols for Patients with Gynecological Tumors. ARS MEDICA TOMITANA 2021. [DOI: 10.2478/arsm-2021-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
It was found that oncological patients are4 to 8 times more likely of developing severe forms of COVID-19 infection than other patients, so mortality is higher in patients with gyneco-logical cancer. Due to this pandemic, reported delays in diagnosis and treatment of genital cancer and changes in disease management, may influence the natural history of neoplasm. This fact adds more stress and fear for patients with neoplasms. Adequate protective measures are essen-tial for SARS CoV2 infection avoidance and lead to changes in healthcare professionals clinical practice. Prioritization is important, but direct personal interactions should be limited. However, gynecological tumors surgery, chemotherapy, and radiotherapy should continue as high priority practices, without essential modification. The conclusion is that COVID-19 pandemic has affect-ed many guides for management of diseases, especially oncological. Adaptations in clinical prac-tice may avoid viral infection and reduce mortality and severe complications.
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Hajibandeh S, Hajibandeh S, Sultana A, Ferris G, Mwendwa J, Mohamedahmed AYY, Zaman S, Peravali R. Simultaneous versus staged colorectal and hepatic resections for colorectal cancer with synchronous hepatic metastases: a meta-analysis of outcomes and clinical characteristics. Int J Colorectal Dis 2020; 35:1629-1650. [PMID: 32653951 DOI: 10.1007/s00384-020-03694-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/06/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVES To evaluate the comparative outcomes and clinical characteristics of simultaneous and staged colorectal and hepatic resections for colorectal cancer with synchronous hepatic metastases. METHODS We conducted a systematic search of electronic information sources, and bibliographic reference lists. Perioperative morbidity and mortality, anastomotic leak, wound infection, bile leak, bleeding, intra-abdominal abscess, sub-phrenic abscess, reoperation, recurrence, 5-year overall survival, procedure time, and length of hospital stay were the evaluated outcome parameters. Combined overall effect sizes were calculated using random-effects model. RESULTS We identified 41 comparative studies reporting a total of 12,081 patients who underwent simultaneous (n = 5013) or staged (n = 7068) resections for colorectal cancer with synchronous hepatic metastases. There were significantly lower use of neoadjuvant chemotherapy (p = 0.003), higher right-sided colonic resections (p < 0.00001), and minor hepatic resections (p < 0.00001) in the simultaneous group. The simultaneous resection was associated with significantly lower rate of bleeding (OR 0.60, p = 0.03) and shorter length of hospital stay (MD - 5.40, p < 0.00001) compared to the staged resection. However, no significant difference was found in perioperative morbidity (OR1.04, p = 0.63), mortality (RD 0.00, p = 0.19), anastomotic leak (RD 0.01, p = 0.33), bile leak (OR 0.83, p = 0.50), wound infection (OR 1.17, p = 0.19), intra-abdominal abscess (RD 0.01, p = 0.26), sub-phrenic abscess (OR 1.26, p = 0.48), reoperation (OR 1.32, p = 0.18), recurrence (OR 1.33, p = 0.10), 5-year overall survival (OR 0.88, p = 0.19), or procedure time (MD - 23.64, p = 041) between two groups. CONCLUSIONS Despite demonstrating nearly comparable outcomes, the best available evidence (level 2) regarding simultaneous and staged colorectal and hepatic resections for colorectal cancer with synchronous hepatic metastases is associated with major selection bias. It is time to conduct high-quality randomised studies with respect to burden and laterality of disease. We recommend the staged approach for complex cases.
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Affiliation(s)
- Shahin Hajibandeh
- Department of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.
| | - Shahab Hajibandeh
- Department of General Surgery, Glan Clwyd Hospital, Rhyl, Denbighshire, UK
| | - Abida Sultana
- Department of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Gabriella Ferris
- Department of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Josiah Mwendwa
- Department of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | | | - Shafquat Zaman
- Department of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Rajeev Peravali
- Department of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
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Cortolillo N, Patel C, Parreco J, Kaza S, Castillo A. Nationwide outcomes and costs of laparoscopic and robotic vs. open hepatectomy. J Robot Surg 2018; 13:557-565. [PMID: 30484059 DOI: 10.1007/s11701-018-0896-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 11/20/2018] [Indexed: 12/16/2022]
Abstract
The safety of hepatectomy continues to improve and it holds a key role in the management of benign and malignant hepatic lesions. Laparoscopic and robotic approaches to hepatectomy are increasingly utilized. The purpose of this study was to compare outcomes and costs of laparoscopic and robotic vs. open approaches to hepatectomy and to determine the national nonelective postoperative readmission rate, including readmission to other hospitals. The Nationwide Readmission Database from 2013 to 2014 was queried for all patients undergoing hepatectomy. Patients undergoing laparoscopic and robotic hepatectomies were compared to patients undergoing open hepatectomy. Multivariate logistic regression was implemented to determine the odds ratios (OR) for non-elective readmission within 45 days. There were 10,870 patients who underwent hepatectomy from 2013 to 2014 and 724 (6.7%) were approached with laparoscopic or robotic technique. The robotic cohort had lower mean cost of the index admission ($24,983 ± $18,329 vs. open $32,391 ± $31,983, p < 0.001, 95% CI - 18,292 to 534), shorter LOS (4.5 ± 3.8 vs. lap 6.8 ± 6.0 vs. open 7.6 ± 7.7 days, p < 0.01), and were less likely to be readmitted within 45 days (7.9% vs. 13.0% lap vs. 13.8% open, p = 0.05). The robotic cohort was slightly younger (mean age 57.5 ± 13.5 vs. lap 60.1 ± 13.8 vs. open 58.9 ± 13.7, p < 0.05), and no significant differences were seen by Charlson Comorbidity Index. Anastomosis of hepatic duct to GI tract carried higher odds of mortality (OR 2.87, p < 0.01) and higher odds of readmission (OR 1.40, p < 0.01). LOS above 7 days increased odds of readmission (OR 2.24, p < 0.01). Nearly one-fifth of patients readmitted after hepatectomy present to a different hospital. Robotic hepatectomy was associated with favorable cost and readmission outcomes compared to laparoscopic and open hepatectomy patients, despite similar patient comorbid burdens and patient's age. Length of stay over 7 days and anastomosis of hepatic duct to GI tract are strong risk factors for readmission and mortality.
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Affiliation(s)
- Nicholas Cortolillo
- Department of Surgery, University of Miami Miller School of Medicine, 5301 S. Congress Av, Atlantis, FL, 33462, USA.
| | - Chetan Patel
- Department of Surgery, University of Miami Miller School of Medicine, 5301 S. Congress Av, Atlantis, FL, 33462, USA
| | - Joshua Parreco
- Department of Surgery, University of Miami Miller School of Medicine, 5301 S. Congress Av, Atlantis, FL, 33462, USA
| | - Srinivas Kaza
- Department of Surgery, University of Miami Miller School of Medicine, 5301 S. Congress Av, Atlantis, FL, 33462, USA
| | - Alvaro Castillo
- Department of Surgery, University of Miami Miller School of Medicine, 5301 S. Congress Av, Atlantis, FL, 33462, USA
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Gothai S, Muniandy K, Gnanaraj C, Ibrahim IAA, Shahzad N, Al-Ghamdi SS, Ayoub N, Veeraraghavan VP, Kumar SS, Esa NM, Arulselvan P. Pharmacological insights into antioxidants against colorectal cancer: A detailed review of the possible mechanisms. Biomed Pharmacother 2018; 107:1514-1522. [DOI: 10.1016/j.biopha.2018.08.112] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 08/21/2018] [Accepted: 08/23/2018] [Indexed: 02/07/2023] Open
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Wu Y, Liu F, Song W, Liang F, Wang L, Xu Y. Safety evaluation of simultaneous resection of colorectal primary tumor and liver metastasis after neoadjuvant therapy: A propensity score matching analysis. Am J Surg 2018; 218:894-898. [PMID: 30268420 DOI: 10.1016/j.amjsurg.2018.09.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 09/10/2018] [Accepted: 09/18/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Considering the surgical safety and perioperative complications, simultaneous resection after neoadjuvant therapy is not commonly recommended. METHODS A total of 253 patients were included in study. Comparison of the short-term outcomes was performed after propensity score adjustment in Group A (n = 96) and Group B (neoadjuvant therapy, n = 96). RESULTS There was no postoperative mortality. After matching, the differences from surgical confounders were well-balanced. Morbidity (15.6% vs. 15.6%, p = 0.981), and Clavien-Dindo grade of complications (p = 0.710) were similar. No difference was found when the complications were divided according to the origin (general, colorectal and hepatic). Length of the hospital stays also did not differ between the groups (p = 0.482). More importantly, there was no increase in the number of patients with delayed adjuvant treatment after surgery in Group B. CONCLUSIONS Neoadjuvant treatment did not increase morbidity, length of hospital stays and influence adjuvant treatment after simultaneous resection.
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Affiliation(s)
- Yuchen Wu
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, No. 270, Dong An Road, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, No. 130, Dong An Road, Shanghai, 200032, China
| | - Fangqi Liu
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, No. 270, Dong An Road, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, No. 130, Dong An Road, Shanghai, 200032, China
| | - Wang Song
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, No. 270, Dong An Road, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, No. 130, Dong An Road, Shanghai, 200032, China
| | - Fei Liang
- Clinical Statistical Center, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, No. 130, Dong An Road, Shanghai, 200032, China
| | - Lu Wang
- Department of Hepatic Surgery, Fudan University Shanghai Cancer Center, No. 270, Dong An Road, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, No. 130, Dong An Road, Shanghai, 200032, China.
| | - Ye Xu
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, No. 270, Dong An Road, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, No. 130, Dong An Road, Shanghai, 200032, China.
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