Two-Stage Surgical Treatment of Unresectable Obstructive Rectal Cancer with Synchronous Hepatic Metastases (original) (raw)
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The treatment of patients with metastatic rectal cancer remains controversial. We developed a reverse strategy, the liver-first approach, to optimize the chance of a curative resection. The aim of this study was to assess rectal outcomes after reverse treatment of patients with metastatic rectal cancer. From May 2000 to November 2013, a total of 34 consecutive selected patients with histology-proven adenocarcinoma of the rectum and liver metastases were prospectively entered into a dedicated computerized database. All patients were treated via our reverse strategy. Rectal and overall survival outcomes were analyzed. Most patients presented with advanced disease (median Fong clinical risk score of 3; range 2-5). One patient failed to complete the whole treatment (3 %). Rectal surgery was performed after a median of 3.9 months (range 0.4-17.8 months). A total of 73.3 % patients received preoperative radiotherapy. Perioperative mortality and morbidity rates were 0 and 27.3 % after rect...