Order of colon versus liver removal during simultaneous surgery for colorectal cancer with liver metastases
Comparison of the Resection Site Order in Simultaneous Approach of Colorectal Liver Metastasis. An International Multicentric Retrospective Trial.
This project tries to see if doing the liver operation before the colon or the colon before the liver changes outcomes for adults having both surgeries at the same time for colorectal cancer that has spread to the liver.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 500 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo di Alessandria Academic / other |
| Drugs / interventions | chemotherapy |
| Locations | 1 site (Alessandria, Piedmont) |
| Trial ID | NCT07272928 on ClinicalTrials.gov |
What this trial studies
This is an observational analysis comparing outcomes by resection order in patients who underwent simultaneous colon and liver removal for colorectal cancer with synchronous liver metastases. Participating cases come from a single surgical center and include minimally invasive and open approaches, with exclusion of emergency resections, extrahepatic disease, and high surgical-risk patients (ASA > 3). Key outcomes include intraoperative blood loss, postoperative complications including anastomotic healing, length of stay, and time to chemotherapy, with at least six months of follow-up required. The study aims to clarify whether resection order affects perioperative results when minor hepatectomies are paired with standard colon resections.
Who should consider this trial
Good fit: Adults with colorectal cancer and synchronous liver metastases who underwent planned simultaneous colon and minor liver resections at the enrolling center and who are ASA class 3 or lower are the ideal candidates for inclusion.
Not a fit: Patients undergoing emergency surgery, those with extrahepatic metastatic disease, those at very high surgical risk (ASA > 3), or those needing major hepatectomy are unlikely to benefit from findings applicable to elective simultaneous resections of minor liver lesions.
Why it matters
Potential benefit: If a clear advantage to one resection order is found, surgeons could adopt that sequence to reduce blood loss, lower complication rates, shorten hospital stays, and allow earlier chemotherapy for eligible patients.
How similar studies have performed: Previous observational series and comparative reports suggest simultaneous resection with minor hepatectomy is safe and that minimally invasive approaches have similar morbidity and oncologic outcomes to open surgery, but data on the optimal resection order are limited and inconsistent.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Adult patients diagnosed with colorectal cancer with synchronous liver metastases during the reference period, who underwent simultaneous resection. Exclusion Criteria: * Simultaneous emergency resection due to symptoms of the primary tumor. * Presence of extrahepatic metastatic disease confirmed at the time of resection or diagnosis. * High surgical risk defined as an ASA risk score greater than 3. * At least 10 cases performed by the invited center during the study period. * Incomplete data or follow-up of less than 6 months.
Where this trial is running
Alessandria, Piedmont
- SC Chirurgia Generale — Alessandria, Piedmont, Italy (Recruiting)
Study contacts
- Study coordinator: Clinical Trial Center
- Email: clinicaltrialcenter@ospedale.al.it
- Phone: 0131206893
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.