Our study showed that time of stent function corresponds to median survival. Greater number of stent migration in group 1 is due to stent coverage, higher incidence of stent dysfunction in group 2 - due to malignant invasion.
Aim. To analyze multimodal treatment outcomes in patients with liver metastases from colorectal cancer, who were treated at multidisciplinary cancer clinic. Material and methods. From 2007 to 2021, 315 colorectal cancer patients with liver metastases underwent liver resections (201, 63.8 %), radiofrequency ablation (RFA) (29, 9.2 %), microwave ablation (MWA) (22, 6.9 %), transarterial chemoembolozation (TACE) in combination with RFA (22, 6.9 %), and TACE + RFA + TACE combination (41, 13.2 %) at the department of liver and pancreas surgery, Moscow Botkin Clinical Hospital. Results. A 90-day mortality rate was 1.9% in 6 patients who underwent liver resection. Postoperative complications after liver resection were observed in 49 patients (24.3 %). The overall 5- and 10-year survival rates after liver resection were 38.8 % and 23.2 %, respectively. The factors of poor prognosis after liver resection were: age over 70 years (p=0.03), localization of the primary tumor in the right half or rectum (p=0.037), three or more metastatic foci in the liver (p=0.01), maximum size of the tumor of more than 5 cm (p=0.021), synchronous colorectal liver metastases (p=0.039), and bilobar colorectal liver metastases (p=0.007). Postoperative complications after RFA, TACE + RFA, TACE + RFA + TACE WERE 5.8 %, 9.1 % and 7.3 %, respectively. In patients with a size of metastases of no more than 3 cm, the 3-year disease-free and overall survival rates after rfa were 45.8 % and 54.2 %, respectively. In patients with a size of metastases from 3 to 5 cm, the 3-year disease-free and overall survival rates after TACE + RFA + TACE were 56.1 % and 63.4 %, respectively. Conclusion. In colorectal cancer patients with liver metastases, multimodal treatment within a multi-disciplinary setting demonstrated significant improvements in their survival.
Aim. To analyze the results of a multidisciplinary approach to the treatment of patients with hepatocellular cancer in a multidisciplinary oncology clinic.Materials and Methods. From 2007 to 2021, 259 patients with hepatocellular cancer were surgically treated in the Department of Liver and Pancreas Surgery of the city clinical hospital named after S.P. Botkin. Liver resections of different extent were performed in 74 (28.6%) patients, radiofrequency ablation – in 19 (7.3%), microwave ablation – in 20 (7.7%), hepatic artery chemoembolization with radiofrequency ablation – in 34 (13.1%), regional chemotherapy – in 104 (40.2%), liver transplantation – in 8 (3.1%) patients.Results. The overall five- and ten-year survival after liver resection was 51.4% and 31.1% respectively. The poor prognostic factors following liver resection were age >70 years (p = 0.03), postoperative complications (p = 0.04), lymph node metastases (p = 0.01), and a body mass index >30 kg/m2 (p = 0.045). Complications that developed after radiofrequency (microwave) ablation and chemoembolization of the hepatic artery with radiofrequency ablation were 5.1% and 5.8%. Within 90 days after liver resection, three (1.1%) patients died. Complications after resection developed in 18 (24.3%) cases during the same period. With metastases measuring ≤3 cm, the overall five-year survival after radiofrequency and microwave ablation was 36.8% and 35% respectively. With neoplasms measuring 3–5 cm, the best five-year survival was after hepatic artery chemoembolization and radiofrequency ablation (44.1%). The overall fiveyear survival after hepatic artery chemoembolization was 11.5%. No complications or deaths resulted from liver transplantation. With an average follow-up period of 12.5 months, none of the patients experienced disease recurrence or died.Conclusion. Using a multidisciplinary approach in a multidisciplinary oncology clinic improves the results of treating patients with hepatocellular cancer.
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