Table 2.

Large retrospective studies focusing on comparison of the simultaneous versus the staged approach for the treatment of colorectal cancer liver metastases

Author	N a	Year	Approach, n	Morbidity, %	Mortality, %	Conclusions
Capussotti [29]	79	2007	31 simul	33	0	Mortality rates are similar in both procedures, so the simultaneous procedure can be performed in carefully selected patients
			48 staged	56	1,3
Lyass [25]	112	2001	26 simul	27	0	Because of lower mortality rates and similar OS compared to staged, Simultaneous resection is a safe and efficient procedure for the treatment of resectable SCRLM
			86 staged	35	2.3
Bolton [35]	165	2000	50 simulb	nr	17	The mortality rate is higher if liver resection is combined with colorectal resection. Therefore, patients should have hepatic resection delayed for at least 3 months after colon resection
			115 staged	nr	1
de Haas [42]	228	2010	55 simul	11	0	The simultaneous approach is safe for limited HR
			173 staged	25	0.6	However, the higher recurrence rate observed in studied patients makes its oncological value and use in clinical practice questionable
Martin RC [33]	230	2009	70 simul	56	0	Morbidity and mortality rates are comparable in both procedures. Therefore, Simultaneous resection is an acceptable option in patients with resectable SCRLM
			160 staged	55	4
Martin R [26]	240	2003	134 simul	49	2	Simultaneous resection should be considered a safe option in patients with resectable SCRLM, because it offers reduced morbidity, shorter treatment time, and similar survival outcomes
			106 staged	67	2
Reddy [37]	610	2007	135 simul	36	1	Simultaneous resection is safe and should be considered for patients with SCRLM; however, due to higher morbidity compared to staged resection only in those patients whose hepatic tumor burden is amenable to minor liver resection (less than three segments)
			475 staged	18	0.5
Nordlinger [34]	1008	1996	115 simul	nr	7	The mortality rate is increased when a major liver resection is performed simultaneously with the resection of the primary tumor
			893 staged	nr	2
						Therefore, this procedure is recommended only if it can be done with a minor liver resection and through the same abdominal incision

^aOnly those studies with N ≥50 were considered in this table.

^bLiver resection was carried out simultaneously with or within 3 months of colorectal resection.

HR, hepatic resection; N, total number of patients; n, number of patients treated with simultaneous or staged resection; nr, not reported; SCRLM, simultaneous colorectal liver metastasis; simul, simultaneous resection of the primary tumor and SCRLM.