Abstract Objectives: To evaluate the characteristics and oncological outcomes of metastatic colorectal cancer (CRC) by comparing patients with synchronous metastasis (SM) and with metachronous metastasis (MM) to assess prognosis and treatment outcomes. Methods: A retrospective analysis was conducted on patients who underwent primary CRC resection between January 2013 and June 2020. They were classified into SM and MM groups. Clinical, pathological, and survival data were analyzed. Primary outcomes included overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS). The secondary outcome was to evaluate the factors associated with poor survival. Results: One hundred seventeen patients (58 synchronous and 59 MM) were included. Those with SM had more severe systemic disease, lower preoperative serum albumin levels, and more right-sided colon cancers. Five-year OS was significantly lower in SM (17.7%) than in MM (35.1%), whereas DSS was similar. Three-year DFS was comparable between SM patients who underwent curative resection and MM patients (9.7% vs. 11.9%, P = 0.23). Three-year OS was significantly higher in SM patients who underwent resection of primary tumor and metastasis than in those who underwent primary tumor resection alone. Liver metastasis and node-positive disease were independent predictors of poor survival. Conclusion: SM is associated with worse OS than is MM. However, curative resection improves outcomes, highlighting the importance of multidisciplinary management in evaluating potential curative surgery.
Nouf Yahya Akeel (Tue,) studied this question.