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

Vera, Ruth; González-Flores, E.; Rubio, Carmen; Urbano, José; Camps, M. Valero; Ciampi-Dopazo, Juan José; Rincón, J. Orcajo; Morillo-Macías, Virginia; Braco, M. A. Gomez; Artacho, G. Suárez

doi:10.1007/s12094-019-02182-z

Cited by 61 publications

(58 citation statements)

References 106 publications

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“…After screening of the fulltext articles, seven studies were ultimately deemed eligible to be included in the analyses. The studies consisted of: one randomized open-label trial and two non-randomized studies comparing SIRT with BSC (Hendlisz et al 2010;Bester et al 2012;Seidensticker et al 2012), two randomized double-blind trials comparing TAS-102 with placebo (Yoshino et al 2012;Mayer et al 2015), and two randomized double-blind trials comparing regorafenib with placebo (the RECOURSE and CONCUR) (Grothey et al 2013;Li et al 2015). While one of the non-randomized studies of SIRT (Bester et al 2012) included patients with both liver metastases secondary to colorectal cancer (66% of subjects) and secondary to other sites (34%), the study was ultimately included as the results from the colorectal primary subgroup were reported separately from the overall population (Bester et al 2012).…”

Section: Search Resultsmentioning

confidence: 99%

“…Regorafenib and TAS-102 are recommended in ESMO, NCCN, French Intergroup, and Spanish consensus clinical guidelines for patients failing fluoropyrimidine-, oxaliplatin-, and irinotecan-based first- and second-line chemotherapy regimens (Van Cutsem et al 2016 ; Benson et al 2020 ; Phelip et al 2019 ; Vera et al 2019 ). SIRT using Y-90 resin microspheres is recommended in the ESMO and French guidelines in a similar setting, for patients with liver-only or liver-dominant colorectal metastases who are refractory or intolerant to chemotherapy, while NCCN guidelines are less specific about the recommended position for SIRT in the therapeutic strategy.…”

Section: Discussionmentioning

confidence: 99%

“…Reporting of the number of treatment lines received by the enrolled patients was inconsistent across studies, making quantitative comparisons between the different study populations difficult. The proportion of patients with extrahepatic disease (aside from the primary (Hendlisz et al 2010;Bester et al 2012;Seidensticker et al 2012;Yoshino et al 2012). Due to the limited data available on response and progression in the SIRT studies, only results for adverse event incidence and OS are presented.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Systematic review and network meta-analyses of third-line treatments for metastatic colorectal cancer

Walter

Hawkins

Pollock³

et al. 2020

J Cancer Res Clin Oncol

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Background Limited treatment options are available in chemotherapy-refractory metastatic colorectal cancer (mCRC). The objective was to conduct a systematic literature review (SLR) and exploratory network meta-analysis (NMA) to compare the tolerability and effectiveness of SIRT with Y-90 resin microspheres, regorafenib, TAS-102 (trifluridine/tipiracil), and best supportive care (BSC) as third-line treatment in patients with mCRC. Methods An SLR was conducted to identify studies comparing two or more of the treatments and reporting overall survival (OS), progression-free survival, tumor response, or adverse event (AE) incidence. An exploratory NMA was conducted to compare hazard ratios (HRs) for OS using Markov chain Monte Carlo (MCMC) techniques. Results Seven studies were identified in the SLR: two double-blind randomized-controlled trials (RCT) for each drug, one open-label RCT, and two non-randomized comparative studies for SIRT. Patient selection criteria differed between studies, with SIRT studies including patients with liver-dominant colorectal metastases. Nausea and vomiting were more frequent with TAS-102 than regorafenib or SIRT; diarrhea was more common with TAS-102 and regorafenib than SIRT. The exploratory NMA suggested that all active treatments improved OS, with HRs of 0.48 (95% CrI 0.30-0.78) for SIRT with Y-90 resin microspheres, 0.63 (0.38-1.03) for TAS-102, and 0.67 (0.40-1.08) for regorafenib each compared to BSC. Conclusions Regorafenib, TAS-102 and SIRT using Y-90 resin microspheres are more effective than BSC in third-line treatment of mCRC; however, study heterogeneity made comparisons between active treatments challenging. SIRT is a viable treatment for third-line mCRC and its favorable AE profile should be considered in the therapeutic decision-making process.

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Section: Search Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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Systematic review and network meta-analyses of third-line treatments for metastatic colorectal cancer

Walter

Hawkins

Pollock³

et al. 2020

J Cancer Res Clin Oncol

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“…A special effort to achieve this goal is being made in colorectal cancer (CRC), one of the most common malignant tumours worldwide [3]. Since 20% of patients with CRC already have liver metastases at the time of diagnosis and up to 50% will develop them within the first 3 years [4], to improve the detection of molecular alterations over time and space of these lesions is crucial to optimise the patient's management [5].…”

Section: Introductionmentioning

confidence: 99%

Impact of inter-reader contouring variability on textural radiomics of colorectal liver metastases

et al. 2020

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Background Radiomics is expected to improve the management of metastatic colorectal cancer (CRC). We aimed at evaluating the impact of liver lesion contouring as a source of variability on radiomic features (RFs). Methods After Ethics Committee approval, 70 liver metastases in 17 CRC patients were segmented on contrast-enhanced computed tomography scans by two residents and checked by experienced radiologists. RFs from grey level co-occurrence and run length matrices were extracted from three-dimensional (3D) regions of interest (ROIs) and the largest two-dimensional (2D) ROIs. Inter-reader variability was evaluated with Dice coefficient and Hausdorff distance, whilst its impact on RFs was assessed using mean relative change (MRC) and intraclass correlation coefficient (ICC). For the main lesion of each patient, one reader also segmented a circular ROI on the same image used for the 2D ROI. Results The best inter-reader contouring agreement was observed for 2D ROIs according to both Dice coefficient (median 0.85, interquartile range 0.78–0.89) and Hausdorff distance (0.21 mm, 0.14–0.31 mm). Comparing RF values, MRC ranged 0–752% for 2D and 0–1567% for 3D. For 24/32 RFs (75%), MRC was lower for 2D than for 3D. An ICC > 0.90 was observed for more RFs for 2D (53%) than for 3D (34%). Only 2/32 RFs (6%) showed a variability between 2D and circular ROIs higher than inter-reader variability. Conclusions A 2D contouring approach may help mitigate overall inter-reader variability, albeit stable RFs can be extracted from both 3D and 2D segmentations of CRC liver metastases.

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“…Colorectal cancer is the most frequent cancer of the digestive tract, being third in order of frequency and fourth in the order of mortality amongst all cancer patients [1]. More than half of all patients with colorectal cancer (CRC) will develop liver metastases during their lifetime [2]. The only hope for a cure is a hepatic resection combined with perioperative chemotherapy, but less than half of all patients are or will become resectable after chemotherapy [3].…”

Section: Introductionmentioning

confidence: 99%

Liver Transplantation for Colorectal Liver Metastases: Current Management and Future Perspectives

Puia-Negulescu

Lebossé

Mabrut

et al. 2021

IJMS

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Patients with nonresectable liver metastases from colorectal cancer have few therapeutic options and a dismal prognosis. Although liver transplantation for this indication has historically a poor reputation, recent advances in the field of chemotherapy and immunosuppression have paved the way to revisit the concept. New data have shown promising results that need to be validated in several ongoing clinical trials. Since liver grafts represent a scarce resource, several new tools are being explored to expand the donor pool for this indication. The purpose of this review is to present all current available data and perspectives about liver transplantation for nonresectable liver metastases from colorectal cancer.

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

Cited by 61 publications

References 106 publications

Systematic review and network meta-analyses of third-line treatments for metastatic colorectal cancer

Systematic review and network meta-analyses of third-line treatments for metastatic colorectal cancer

Impact of inter-reader contouring variability on textural radiomics of colorectal liver metastases

Liver Transplantation for Colorectal Liver Metastases: Current Management and Future Perspectives

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