Liver Resection for Colorectal Metastases

Adam, René; Pascal, G.; Azoulay, Daniel; Tanaka, Kuniya; Castaing, Denis; Bismuth, H

doi:10.1097/01.sla.0000098112.04758.4e

Cited by 378 publications

(224 citation statements)

References 36 publications

Supporting

Mentioning

185

Contrasting

Unclassified

Order By: Relevance

“…In recent years, however, advances in early diagnosis and surgical procedures appear to offer better long-term survival and cure in patients with limited CLM who are resectable, with a reported median survival of 35 -69 months. Large series report 5-year and 10-year survival rates as high as 51 and 27%, respectively, following hepatectomy in this setting (Scheele et al, 1995;Fong et al, 1999;Bolton and Fuhrman, 2000;Sugawara et al, 2001;Choti et al, 2002;de Santibanes et al, 2002;Adam et al, 2003).…”

mentioning

confidence: 99%

Predictors of survival after hepatic resection among patients with colorectal liver metastasis

et al. 2007

View full text Add to dashboard Cite

Studies suggest improved survival following resection of colorectal cancer liver metastases (CLMs). We investigated predictors of survival among patients with CLM who underwent hepatic resection using the SEER-Medicare database to identify patients X65 years diagnosed with CLM, 1991CLM, -2003, who underwent hepatectomy. Cox proportional hazards models were used to identify factors associated with survival after hepatectomy. Of 923 patients with CLM who underwent hepatectomy, 514 were stages I -III and developed CLM46 months after diagnosis (metachronous), and 409 were stage IV with CLM at diagnosis (synchronous). From the date of hepatectomy, 5 year survival was 22%; younger age, being married, female gender, surgery in an NCI-designated cancer centre, fewer comorbidities, fewer positive lymph nodes, and lower grade were associated with improved survival. Both 5-fluorouracil (5FU)-based chemotherapy and hepatic arterial infusion (HAI) of floxuridine-based chemotherapy following hepatectomy improved survival (HR ¼ 0.62, 95% CI: 0.50 -0.78; HR ¼ 0.51, 95% CI: 0.28 -0.97, respectively) in the synchronous, but not metachronous, group. The HR for overall mortality was higher in hospitals with a high vs low procedure volume (0.75, 95% CI: 0.58 -0.94). A substantial subgroup of patients with CLM who undergo hepatectomy experiences long-term survival. High hospital procedure volume and use of 5FU-based or HAI-based chemotherapy after resection were associated with improved prognosis.

show abstract

mentioning

confidence: 99%

Predictors of survival after hepatic resection among patients with colorectal liver metastasis

et al. 2007

View full text Add to dashboard Cite

show abstract

“…Fifty per cent of these patients will either present with or develop liver metastases in the course of their disease (Scheele et al, 1990(Scheele et al, , 1995Sugarbaker, 1990;Stangl et al, 1994). Of these, 20 -30% are suitable for resection, which currently offers the greatest chance of cure, with a 5-year survival after curative liver resection being 25 -40% (Hughes et al, 1986;Stangl et al, 1994;Scheele et al, 1995;Nordlinger et al, 1996;Rees et al, 1997;Fong et al, 1999;Adam et al, 2003).…”

mentioning

confidence: 99%

Safe liver resection following chemotherapy for colorectal metastases is a matter of timing

et al. 2007

View full text Add to dashboard Cite

Neoadjuvant chemotherapy (NC) can improve the resectability of hepatic colorectal metastases (CRM). However, there is concern regarding its impact on operative risk. We reviewed 750 consecutive liver resections performed for CRM in a single unit (1996 -2005) to evaluate whether NC affected morbidity and mortality. Redo hepatic resections or patients receiving adjuvant chemotherapy following primary resection were excluded. A total of 245 resections were performed in patients not requiring NC (control group) (mean age 63, 67% male) and 252 in patients who had NC (mean age 62, 67% male). The mean (s.d.) duration of surgery was less in the control group (241(64) vs 255(64)min, P ¼ 0.014) as was the mean blood loss (390(264) vs 449(424)ml, P ¼ 0.069). Postoperative mortality (2 vs 2%) and morbidity (27 vs 29%, P ¼ 0.34) was similar between groups. More NC patients developed septic (2.4%) or respiratory (10.3%) complications compared to controls (0 and 5.3%, Po0.03), with significantly more surgical complications if the interval between stopping NC and undergoing surgery was p4 weeks (11%), compared to 5 -8 (5.5%) or 9 -12 (2.6%) weeks (P ¼ 0.009). The data suggest that liver resection for CRM is safe following NC. Early hepatobiliary involvement in multidisciplinary cancer care may lead to avoidance of potential perioperative adverse events.

show abstract

“…En 30% de los casos esta recidiva es exclusivamente hepática 7 . Por lo anterior, se han planteado las re-resecciones ante la aparición de nuevas metástasis 7,30 . En esta serie se realizaron 8 segundas hepatectomías, con buenos resultados y sobrevida a largo plazo.…”

Section: Discussionunclassified

Resultados del tratamiento quirúrgico de las metástasis hepáticas por cáncer colorrectal

et al. 2009

View full text Add to dashboard Cite

Outcome of surgical treatment of liver metastasis from colorectal cancer 1 (1990-1997) and period 2 (1998-2007 (77% and 55%, respectively, p =0.04), without an increase in complications (35% and 34%, respectively; p =ns), but with a better five years survival (45% and 21%, respectively, p =0.04). Conclusions: Five years survival for excision of liver metastatic colorectal cancer in our center is similar to that reported abroad. During the second period there has been a trend toward more extensive resections which was associated with a better survival, without an increase in complications or mortality (Rev Méd Chile 2009; 137: 487-96).

show abstract

Liver Resection for Colorectal Metastases

Abstract: Third hepatectomy is safe and provides an additional benefit of survival similar to that of first and second liver resections. It is worthwhile when curative and integrated into an intended multimodal strategy of tumoral eradication.

Cited by 378 publications

References 36 publications

Predictors of survival after hepatic resection among patients with colorectal liver metastasis

Predictors of survival after hepatic resection among patients with colorectal liver metastasis

Safe liver resection following chemotherapy for colorectal metastases is a matter of timing

Resultados del tratamiento quirúrgico de las metástasis hepáticas por cáncer colorrectal

Contact Info

Product

Resources

About