Multidisciplinary treatment of colorectal liver metastases

Schiergens, TS; J, von Einem; Mn, Thomas; Albertsmeier, Markus; Gießen-Jung, Clemens; Dörsch, M; Heiliger, Christian; Drefs, Moritz; Andrassy, Joachim; Dp, Modest; Stintzing, Sebastian; Guba, M.; Angele, Martin K.; Werner, Josefin Björk; Rentsch, Markus

doi:10.23736/s0026-4806.17.05371-x

Cited by 14 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Multidisciplinary treatment and the current transition to personalized therapy bring major improvements and push the limits of curative treatment in metastatic forms of colorectal cancer. Surgical procedures aimed at complete tumor clearance represent the central instrument to achieve long-term survival [45].…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Approach of Colo-Rectal and Hepatic Lesions in Colo-Rectal Cancers With Liver Metastasis – A Single Oncological Center Overview

Simion¹,

Rotaru²,

Cirimbei³

et al. 2022

Preprint

View full text Add to dashboard Cite

Management of synchronous colorectal cancer with liver metastases (SCLM) is still on debate, regarding timing, indications and complications of the 3 strategies: classic approach (first tumor resection), simultaneous resection and reverse approach (liver first). A retrospective single-centre evaluation of synchronous approach was accomplished, focusing on surgical technique, indications and perioperative complications. Between 2017 and 2020, 31 SCLM patients benefited from synchronously colorectal and hepatic approach: segmental colectomies/rectal resections, simultaneously with liver metastasectomies (associated with radiofrequency ablation). Post-therapeutic imaging monitoring was performed from every 3 to 6 months. There were no perioperative complications related to the combination of the two procedures, low morbidity and zero postoperative mortality. The follow-up period was from 10 to 40 months: 13 patients had no evidence of recurrence, 10 patients had hepatic metastases in regression, 4 of them had signs of peritoneal carcinomatosis and 4 patients showed progression of liver disease; all patients were on chemotherapy. During follow-up 4 patients died. Experience shows that the simultaneous approach of recto-colic and hepatic resections in colo-rectal cancers is a safe procedure, with low morbidity, the limits being dictated by the size of the liver metastases. The results at long-distance must be drawn by further consistent trials.

show abstract

Section: Discussionmentioning

confidence: 99%

Simultaneous Approach of Colo-Rectal and Hepatic Lesions in Colo-Rectal Cancers With Liver Metastasis – A Single Oncological Center Overview

Simion¹,

Rotaru²,

Cirimbei³

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…7 In recent years, expansion of the indications for liver resection and the availability of new regimens of systemic chemotherapy have altered the treatment strategy for colorectal liver metastases (CRLM) and improved postoperative outcomes. 8,9 For resectable CRLM, liver resection remains the main potentially curative treatment for long-term patient survival. 10 The 5-year overall survival (OS) rate approaches 50% in patients suitable for radical surgery.…”

Section: Introductionmentioning

confidence: 99%

Postoperative adjuvant chemotherapy is important for improving long‐term survival in patients with colorectal cancer liver metastases undergoing simultaneous resection

Zhong,

Xu,

et al. 2024

J of Gastro and Hepatol

View full text Add to dashboard Cite

Background and AimA growing number of studies have demonstrated that neoadjuvant chemotherapy can improve the prognosis of patients with resectable colorectal liver metastases (CRLM). However, the routine use of postoperative adjuvant chemotherapy (POAC) for patients with CRLM after simultaneous resection remains controversial. This retrospective study investigated the impact of POAC on outcomes in patients with CRLM who underwent simultaneous resection of colorectal cancer tumors and liver metastases using propensity score matching (PSM) analysis.MethodsFrom January 2009 to November 2020, patients with CRLM who underwent simultaneous resection were retrospectively enrolled. The confounding factors and selection bias were adjusted by 2:1 PSM. Patients were stratified into the POAC and non‐POAC groups. Kaplan–Meier curves were utilized to compare overall survival (OS) and progression‐free survival (PFS) between the groups. Univariate and multivariate Cox regression analyses were used to identify independent clinicopathological factors before and after PSM analysis. The utility of the model was evaluated using receiver operating characteristic (ROC) and calibration curves after PSM analysis.ResultsIn total, 478 patients with resectable CRLM were enrolled and assigned to the POAC (n = 212, 60.9%) or non‐POAC group (n = 136, 39.1%). After 2:1 PSM, there was no significant bias between the groups. Kaplan–Meier survival analysis revealed a significant effect of POAC on OS (P < 0.001) but not PFS. Multivariate Cox regression analysis identified T stage (T3–T4), lymph node metastasis, radiofrequency ablation during surgery, operative time ≥ 325 min, and the receipt of postoperative adjuvant chemotherapy (hazard ratio = 0.447, 95% confidence interval = 0.312–0.638, P < 0.001) as independent prognostic factors for OS. The areas under the ROC curves for the nomogram model for predicting 1‐, 3‐, and 5‐year survival were 0.653, 0.628, and 0.678, respectively. Subgroups analysis suggested that POAC can enhance OS in patients with resectable CRLM with either low (1–2, P < 0.001) or high clinical risk scores (3–5, P = 0.020).ConclusionsOverall, this study identified POAC as a prognostic factor to predict OS in patients with CRLM undergoing simultaneous resection.

show abstract

Chances, challenges and outcomes of patients with complex bilobar colorectal liver metastases approached by a combined multimodal therapy with liver resection and local ablative therapy

Drefs

Schoenberg

Schiergens

et al. 2021

Journal of Surgical Oncology

View full text Add to dashboard Cite

Background and Objectives: In treatment of colorectal liver metastases (CRC-LM), liver surgery combined with systemic therapies and local ablation (LAT) allows improved survival. This study aims at the outcomes of patients with complex bilobar CRC-LM who were intended to undergo multimodal therapy with liver resection and LAT. Methods: Forty-three CRC-LM patients with recommendation for multimodal treament were extracted from 5878 tumor board decisions between 2014 and 2017. Outcome variables included patient survival, as well as completion of hepatic clearance. Prognostic factors were identified by correlation and a Cox proportional hazards model. Results: Out of 43 patients only 23 achieved complete clearance of CRC-LM. Oneand 3-year overall survival of patients with cleared liver disease was 100% and 91.7%, respectively, as compared to 83.8% and 12.1%. Incomplete hepatic clearance was the strongest independent risk factor for overall survival (hazards ratio [HR],

show abstract

Multidisciplinary treatment of colorectal liver metastases

Cited by 14 publications

References 0 publications

Simultaneous Approach of Colo-Rectal and Hepatic Lesions in Colo-Rectal Cancers With Liver Metastasis – A Single Oncological Center Overview

Simultaneous Approach of Colo-Rectal and Hepatic Lesions in Colo-Rectal Cancers With Liver Metastasis – A Single Oncological Center Overview

Postoperative adjuvant chemotherapy is important for improving long‐term survival in patients with colorectal cancer liver metastases undergoing simultaneous resection

Chances, challenges and outcomes of patients with complex bilobar colorectal liver metastases approached by a combined multimodal therapy with liver resection and local ablative therapy

Contact Info

Product

Resources

About