The Italian Consensus on minimally invasive simultaneous resections for synchronous liver metastasis and primary colorectal cancer: A Delphi methodology

Aldo Rocca, Federica Cipriani, Giulio Belli, Stefano Berti, Ugo Boggi, Vincenzo Bottino, Umberto Cillo, Matteo Cescon, Matteo Cimino, Francesco Corcione, Luciano De Carlis, Maurizio Degiuli, Paolo De Paolis, Agostino Maria De Rose, Domenico D’Ugo, Fabrizio Di Benedetto, Ugo Elmore, Giorgio Ercolani, Giuseppe M. Ettorre, Alessandro FerreroMarco Filauro, Felice Giuliante, Salvatore Gruttadauria, Alfredo Guglielmi, Francesco Izzo, Elio Jovine, Andrea Laurenzi, Francesco Marchegiani, Pierluigi Marini, Marco Massani, Vincenzo Mazzaferro, Michela Mineccia, Francesco Minni, Andrea Muratore, Simone Nicosia, Riccardo Pellicci, Riccardo Rosati, Nadia Russolillo, Antonino Spinelli, Gaya Spolverato, Guido Torzilli, Giovanni Vennarecci, Luca Viganò, Leonardo Vincenti, Paolo Delrio, Fulvio Calise, Luca Aldrighetti

Research output: Contribution to journalArticlepeer-review


At the time of diagnosis synchronous colorectal cancer, liver metastases (SCRLM) account for 15–25% of patients. If primary tumour and synchronous liver metastases are resectable, good results may be achieved performing surgical treatment incorporated into the chemotherapy regimen. So far, the possibility of simultaneous minimally invasive (MI) surgery for SCRLM has not been extensively investigated. The Italian surgical community has captured the need and undertaken the effort to establish a National Consensus on this topic. Four main areas of interest have been analysed: patients’ selection, procedures, techniques, and implementations. To establish consensus, an adapted Delphi method was used through as many reiterative rounds were needed. Systematic literature reviews were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses instructions. The Consensus took place between February 2019 and July 2020. Twenty-six Italian centres participated. Eighteen clinically relevant items were identified. After a total of three Delphi rounds, 30-tree recommendations reached expert consensus establishing the herein presented guidelines. The Italian Consensus on MI surgery for SCRLM indicates possible pathways to optimise the treatment for these patients as consensus papers express a trend that is likely to become shortly a standard procedure for clinical pictures still on debate. As matter of fact, no RCT or relevant case series on simultaneous treatment of SCRLM are available in the literature to suggest guidelines. It remains to be investigated whether the MI technique for the simultaneous treatment of SCRLM maintain the already documented benefit of the two separate surgeries.

Original languageEnglish
JournalUpdates in Surgery
Publication statusPublished - 2021


  • Colorectal cancer
  • Consensus
  • Minimally invasive surgery
  • Synchronous colorectal liver metastases

ASJC Scopus subject areas

  • Surgery


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