Selection for local treatment and outcomes of surgical resection in patients with synchronous colorectal liver metastases: A nationwide population-based study
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: The aim of this study was to evaluate potential disparities in the probability of undergoing surgical treatment among patients with synchronous colorectal liver metastases (CRLM) and to investigate which non-tumour-related characteristics influenced postoperative outcomes. METHODS: This was a population-based study of all patients diagnosed with synchronous CRLM between 2015 and 2021 in the Netherlands. Data were retrieved from the Netherlands Cancer Registry (NCR) and data of patients who underwent surgical exploration were retrieved from the Dutch Hepato Biliary Audit (DHBA). The association between non-tumour-related factors, the chance of getting local treatment of CRLM and outcomes after resection were evaluated using multivariable logistic regression models. RESULTS: From the NCR, 14,047 patients with synchronous CRLM were included. Of these 2753 (20 %) patients underwent local treatment of CRLM. Non-tumour-related factors associated with a lower likelihood of local treatment of CRLM included age (OR 0.94 95 %CI 0.94-0.95) and female sex (OR 0.87, 95 %CI 0.78-0.97). Middle and high Socioeconomic status (SES) compared to low SES (respectively OR 1.35, 95 %CI 1.18-1.54 and OR 1.61, 95 %CI 1.41-1.84) and presentation in a hospital that performed liver surgery (OR 1.52, 95 %CI 1.26-1.84) were associated with a higher likelihood of getting local treatment. From the DHBA 2535 patients were included. Non-tumour-related factors associated with both major morbidity and mortality included age (OR 1.01 95 %CI 1.00-1.03 and OR 1.07, 95 %CI 1.02-1.11, respectively) and ASA-score ≥3 (OR 1.7,95 %CI 1.34-2.29 and OR 2.88, 95 CI 1.92-1.11) respectively. CONCLUSION: In addition to tumour-related factors, non-tumour-related factors, including age, male sex, SES and hospital of presentation, all contributed to the likelihood of getting local treatment for CRLM. As not all these factors influence postoperative outcomes, healthcare systems should also focus on eliminating barriers to accessing appropriate care.
Authors: Michelle R. de Graaff, Joost M. Klaase, Macel den Dulk, Dirk J. Grünhagen, R.-J. Swijnenburg, G. Kazemier, M. Liem, E.J.T. Belt, M. Vermaas, J.S.D. Mieog, P. Gobardhan, A. Rijken, S.J. Oosterling, K. Bosscha, Niels F.M. Kok, MarloesA.G. Elferink, Hans Torrenga, N. Tjarda van Heek, C.I. Buis, Wouter Derksen, Jeroen Hagendoorn, Wouter K.G. Leclercq, Koert Kuhlmann, Peter van den Boezem, Eric R. Manusama, Peter van Duijvendijk, Gijs Patijn
Institutions: University Medical Center Groningen, Dutch Institute for Clinical Auditing, Maastricht University Medical Centre, Maastricht University, Erasmus MC, Amsterdam UMC Location University of Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Medisch Spectrum Twente, Albert Schweitzer Ziekenhuis, IJsselland Ziekenhuis, Leiden University Medical Center, Amphia Ziekenhuis, Spaarne Gasthuis, Jeroen Bosch Ziekenhuis, The Netherlands Cancer Institute, Netherlands Comprehensive Cancer Organisation
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,810
OpenAlex ID: W4413801540