Long-term results of liver-first approach strategy in patients with advanced synchronous liver metastases from colorectal cancer

被引:0
作者
Fonollosa, Eric Herrero [1 ]
Recasens, Maria Galofre [1 ]
Pinedo, Alba Zarate [2 ]
Domingo, Maria Isabel Garcia [1 ]
Lasa, Judith Camps [1 ]
Aranda, Fernando Pardo [2 ]
Alvarez, Francisco Espin [2 ]
Andorra, Esteban Cugat [1 ,2 ]
机构
[1] Hosp Univ Mutua Terrassa, Serv Cirugia Gen & Aparato Digest, Unidad Cirugia HBP, Terrassa, Barcelona, Spain
[2] Hosp Badalona Germans Trias & Pujol, Serv Cirugia Gen & Aparato Digest, Unidad Cirugia HBP, Badalona, Barcelona, Spain
来源
CIRUGIA ESPANOLA | 2023年 / 101卷 / 05期
关键词
Liver metastases; Liver-first approach; Liver surgery; Synchronous metastases; RESECTION; MANAGEMENT; IMPACT;
D O I
10.1016/j.ciresp.2022.04.007
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: The "liver-first" approach (LFA) is a strategy indicated for advanced synchronous liver metastases (ASLM) from colorectal cancer (CRC). Includes neoadjuvant chemotherapy, resection of the ASLM followed by CRC resection. Methods: Retrospective descriptive analysis from a prospective database of hepatectomies from liver metastases (LM) from CRC in two centers. Between 2007-2019, 88 patients with CRC-ASLM were included in a LFA scheme. Bilobar (LM) was present in 65.9%, the mean number of lesions was 5.5 and mean size 42.7 mm. Response to treatment was assessed by RECIST criteria. Progression-free survival (PFS) and overall survival (OS) were estimated using Kaplan-Meier survival curves. Results: Seventy-five of 88 patients (85.2%) completed the LFA. RECIST evaluation showed partial response in 75.7% and stable disease in 22.8%. Severe morbidity rate (Clavien-Dindo >= IIIA) after liver and colorectal surgery was present in 29.4% and 9.3%, respectively. There was no 90-day postoperative mortality in both liver and colorectal surgeries. Recurrence rate was 76%, being the liver the most frequent site, followed by the pulmonary. From the total number of recurrences (106) in 56 patients, surgical with chemotherapy rescue treatment was accomplished in 34 of them (32.1%). The mean PFS was 8.5 and 5-year OS was 53%. Conclusions: In patients with CRC-ASLM the LFA allows control of the liver disease before-hand and an assessment of the tumor response to neoadjuvant chemotherapy, optimising the chance of potentially curative liver resection, which influences long-term survival. (c) 2022 AEC. Published by Elsevier Espana, S.L.U. All rights reserved.
引用
收藏
页码:341 / 349
页数:9
相关论文
共 50 条
[41]   Impact of the strategy for curative treatment of synchronous colorectal cancer liver metastases [J].
Raoux, L. ;
Maulat, C. ;
Mokrane, F. -Z. ;
Fares, N. ;
Suc, B. ;
Muscari, F. .
JOURNAL OF VISCERAL SURGERY, 2020, 157 (04) :289-299
[42]   Impact of Resection for Primary Colorectal Cancer on Outcomes in Patients with Synchronous Colorectal Liver Metastases [J].
Huh, Jung Wook ;
Cho, Chol Kyoon ;
Kim, Hyeong Rok ;
Kim, Young Jin .
JOURNAL OF GASTROINTESTINAL SURGERY, 2010, 14 (08) :1258-1264
[43]   Impact of Resection for Primary Colorectal Cancer on Outcomes in Patients with Synchronous Colorectal Liver Metastases [J].
Jung Wook Huh ;
Chol  Kyoon Cho ;
Hyeong Rok Kim ;
Young Jin Kim .
Journal of Gastrointestinal Surgery, 2010, 14 :1258-1264
[44]   Optimizing the approach to patients with potentially resectable liver metastases from colorectal cancer [J].
Lim, Elgene ;
Thomson, Benjamin N. J. ;
Heinze, Stefan ;
Chao, Michael ;
Gunawardana, Dishan ;
Gibbs, Peter .
ANZ JOURNAL OF SURGERY, 2007, 77 (11) :941-947
[45]   Long-term outcome of Stereotactic Body Radiation Therapy for patient with unresectable liver metastases from colorectal cancer [J].
Py, J. F. ;
Salleron, J. ;
Courrech, F. ;
Beckendorf, V ;
Croise-Laurent, V ;
Peiffert, D. ;
Vogin, G. ;
Dietmann, A. S. .
CANCER RADIOTHERAPIE, 2021, 25 (04) :350-357
[46]   Timing of Resection for Synchronous Liver Metastases from Colorectal Cancer [J].
Kaibori, Masaki ;
Iwamoto, Shigeyoshi ;
Ishizaki, Morihiko ;
Matsui, Kosuke ;
Saito, Takamichi ;
Yoshioka, Kazuhiko ;
Hamada, Yoshinori ;
Kwon, A. Hon .
DIGESTIVE DISEASES AND SCIENCES, 2010, 55 (11) :3262-3270
[47]   Long-term global quality of life in patients treated for colorectal liver metastases [J].
Wiering, B. ;
Oyen, W. J. G. ;
Adang, E. M. M. ;
van der Sijp, J. R. M. ;
Roumen, R. M. ;
de Jong, K. P. ;
Ruers, T. J. M. ;
Krabbe, P. F. M. .
BRITISH JOURNAL OF SURGERY, 2011, 98 (04) :565-571
[48]   The Role of Chemotherapy in Patients with Synchronous Colorectal Liver Metastases: A Nationwide Study [J].
Sternby, Hanna ;
Brandt, Farima ;
Sanjeevi, Srinivas ;
Unosson, Jon ;
Reda, Souheil ;
Muszynska, Carolina ;
Urdzik, Jozef ;
Fruehling, Petter .
CANCERS, 2025, 17 (06)
[49]   Surgical approach to synchronous colorectal liver metastases: staged, combined, or reverse strategy [J].
Lillemoe, Heather A. ;
Vauthey, Jean-Nicolas .
HEPATOBILIARY SURGERY AND NUTRITION, 2020, 9 (01) :25-34
[50]   Synchronous and metachronous liver metastases in patients with colorectal cancer-towards a clinically relevant definition [J].
Engstrand, Jennie ;
Stromberg, Cecilia ;
Nilsson, Henrik ;
Freedman, Jacob ;
Jonas, Eduard .
WORLD JOURNAL OF SURGICAL ONCOLOGY, 2019, 17 (01)