Metástasis Hepáticas De Origen Colorrectal Sincrónicas: ¿intervención Simultánea O Secuencial?

Abstract

simultaneous or sequential treatment of liver metastases of colon cancer? experience in 76 patientsBackground: Synchronous liver metastases of colon cancer can be managed with sequential or simultaneous surgical management of the primary tumor and the metastases. aim: To compare the evolution of patients whose liver metastases were treated sequentially or simultaneously. Material and Methods: Retrospective analysis of 76 patients aged 63 ± 11 years (67% males). In 25, metastases were managed simultaneously and in 51 there were treated sequentially after a period of chemotherapy. All interventions were performed by the same surgeon. results: Patients treated sequentially had a higher number of metastases and more lymph nodes involved than their counterparts treated simultaneously. The overall resectability index was 78%. Eighteen major and 28 minor hepatic resections were carried out. Significantly more major resections were carried out in the sequential treatment group. Mean hospital stay was 11 days and 20% of patients had complications, with no differences between groups. Survival at one, three and five years was 75, 45 and 36% in the simultaneous treatment and 76, 49 and 29% in the sequential treatment group (with no significant differences between groups). conclusions: In this group of patients no differences in complications or survival were observed when liver metastases were treated simultaneously or sequentially. However groups were not homogeneous.

Metástasis hepáticas en el cáncer colorrectal: estrategias terapéuticas y recomendaciones actuales

“…A pesar de las diferentes estrategias propuestas, no existe claridad sobre cuándo se debe usar cada uno de los métodos y si en algún caso en particular es preferible el uno sobre el otro. Sin embargo, en algunos estudios comparativos se ha demostrado una supervivencia equivalente con los diferentes esquemas terapéuticos, siempre y cuando se logren implementar totalmente 99,100 .…”

Synchronous Liver Metastases of Colorectal Cancer

“…El hígado es el lugar más frecuente a la hora de localizarse las metástasis de este cáncer 5 . Actualmente aumentan los grupos que optan por una cirugía simultánea del primario y de las metástasis si se cumplen algunas condiciones: que no haya enfermedad extrahepática; que las metástasis puedan ser resecadas por el mismo abordaje que el tumor primario; que se pueda hacer una resección R0 dejando un volumen aceptable de hígado sano; que el cirujano sea experto y que el paciente no presente comorbilidad importante 4 .…”