Complex Surgical Strategies to Improve Resectability in Borderline-Resectable Disease

Qadan, Motaz; D’Angelica, Michael I.

doi:10.1007/s11888-015-0290-5

Cited by 16 publications

(9 citation statements)

References 88 publications

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“…Treatment is focused on improving the volume and function of FLR [54]. FLR of 25% is considered the minimum safe volume needed after hepatic resection in patients with a normal liver.…”

Section: R0 Resection Is Feasible But Flr Is Inadequate In Volume Ormentioning

confidence: 99%

Multidisciplinary management of liver metastases in patients with colorectal cancer: a consensus of SEOM, AEC, SEOR, SERVEI, and SEMNIM

et al. 2019

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Colorectal cancer (CRC) has the second-highest tumor incidence and is a leading cause of death by cancer. Nearly 20% of patients with CRC will have metastases at the time of diagnosis, and more than 50% of patients with CRC develop metastatic disease during the course of their disease. A group of experts from Medicine and Molecular Imaging met to discuss and provide a multidisciplinary consensus on the management of liver metastases in patients with CRC. The group defined the different scenarios in which the disease can present: fit or unfit patients with resectable liver metastases, patients with potential resectable liver metastases, and patients with unresectable liver metastases. Within each scenario, the different strategies and therapeutic approaches are discussed.

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“…Treatment is focused on improving the volume and function of FLR [54]. FLR of 25% is considered the minimum safe volume needed after hepatic resection in patients with a normal liver.…”

Section: R0 Resection Is Feasible But Flr Is Inadequate In Volume Ormentioning

confidence: 99%

Multidisciplinary management of liver metastases in patients with colorectal cancer: a consensus of SEOM, AEC, SEOR, SERVEI, and SEMNIM

et al. 2019

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“…1 The liver is the most common site of metastatic disease, and is involved approximately 80% of the time. Multimodal medical and surgical therapies for the treatment of metastatic disease have significantly evolved over the last 2 decades.…”

Section: Introductionmentioning

confidence: 99%

Robotic hepatic arterial infusion pump placement

Qadan

D’Angelica

Kemeny

et al. 2017

HPB

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Introduction Hepatic artery infusion pump (HAIP) placement is associated with improved outcomes in the treatment of colorectal liver metastases (CRLM). In this study, we examined outcomes following robotic HAIP placement, which were compared with open and laparoscopic placement. Methods A retrospective review of HAIP placements by 2 surgeons at a single institution was carried out from a prospectively maintained institutional cancer database. The institutional review board approved this HIPAA-compliant study. All statistical tests were 2-sided and p < 0.05 was considered significant. Results There were a total of 53 open HAIP cases, 21 laparoscopic cases, and 24 robotic cases. There were no statistically significant differences between the 3 groups in gender, age, body mass index, aberrant arterial anatomy, disease process being treated, or prior treatment, including chemotherapy, or prior abdominal or hepatic surgical intervention (p > 0.05). Robotic HAIP placement was associated with a significantly lower conversion rate to open operation than laparoscopic pump placement (17 vs. 67%; p = 0.0009). When cases with concomitant resections were excluded, there was a trend towards shorter median length of hospital stay with robotic pump placement compared with open and laparoscopic placement (4 vs. 5 vs. 5 days, respectively; p = 0.09). Complication rates were equivalent among the 3 groups when concomitant resections were excluded. Conclusion Robotic HAIP placement is a safe minimally-invasive procedure that is associated with a significantly lower conversion rate to open operation compared with laparoscopic placement and a trend towards shorter hospitalization compared to open.

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“…A search of “colorectal liver metastases” AND “borderline resectable” or “potentially resectable” in the abstract by using the literature search tool PubMed found 76 related reports, but only nine actually referred in detail to borderline resectable as an aspect of CRLM[ 3 , 42 - 49 ]. The concept of borderline resectable was first discussed by Jean-Nicolas Vauthey in 2007, and the resectable cases of CRLM were a very heterogeneous population; notably, patients with extrahepatic lesions and those with R1 surgery had a clearly poor prognosis.…”

Section: Borderline Resectable For Crlmmentioning

confidence: 99%

“…Liver metastasis is found in about 20% of cases when CRC is diagnosed, and more than half of CRC patients have liver metastasis during the course[ 2 ]. Colorectal liver metastases (CRLM) is one of the cancers for which long-term prognosis or curative treatment can be enhanced by the resection of metastatic lesions, and this can provide a 5-year survival rate of about 25%-74%[ 3 ]. However, only about 20% of cases are indicated for resection at the time of diagnosis of liver metastasis (categorized as initially resectable).…”

Section: Introductionmentioning

confidence: 99%

Borderline resectable for colorectal liver metastases: Present status and future perspective

Kitano

Hayashi

Matsumoto

et al. 2021

WJGS

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Surgical resection for colorectal liver metastases (CRLM) may offer the best opportunity to improve prognosis. However, only about 20% of CRLM cases are indicated for resection at the time of diagnosis (initially resectable), and the remaining cases are treated as unresectable (initially unresectable). Thanks to recent remarkable developments in chemotherapy, interventional radiology, and surgical techniques, the resectability of CRLM is expanding. However, some metastases are technically resectable but oncologically questionable for upfront surgery. In pancreatic cancer, such cases are categorized as “borderline resectable”, and their definition and treatment strategies are explicit. However, in CRLM, although various poor prognosis factors have been identified in previous reports, no clear definition or treatment strategy for borderline resectable has yet been established. Since the efficacy of hepatectomy for CRLM was reported in the 1970s, multidisciplinary treatment for unresectable cases has improved resectability and prognosis, and clarifying the definition and treatment strategy of borderline resectable CRLM should yield further improvement in prognosis. This review outlines the present status and the future perspective for borderline resectable CRLM, based on previous studies.

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Complex Surgical Strategies to Improve Resectability in Borderline-Resectable Disease

Cited by 16 publications

References 88 publications

Multidisciplinary management of liver metastases in patients with colorectal cancer: a consensus of SEOM, AEC, SEOR, SERVEI, and SEMNIM

Multidisciplinary management of liver metastases in patients with colorectal cancer: a consensus of SEOM, AEC, SEOR, SERVEI, and SEMNIM

Robotic hepatic arterial infusion pump placement

Borderline resectable for colorectal liver metastases: Present status and future perspective

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