Referral patterns of patients with liver metastases due to colorectal cancer for resection

Al-Sahaf, Osama; Al-Azawi, Dhafir; Al-Khudairy, Ammar; Fauzi, Mohammad Z.; El‐Masry, Sherif; Gilen, Peter

doi:10.1007/s00384-008-0561-6

Cited by 4 publications

(4 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other studies have demonstrated that survival rates can be further increased by both careful patient selection and centralizing liver surgery in dedicated centers. 26,27 In contrast to the association between hospital of diagnosis and the chance of undergoing a liver resection, no association was found between hospital of diagnosis and survival. This might indicate that hospitals use different criteria to select patients for liver resection.…”

Section: Discussioncontrasting

confidence: 68%

Large variation in the utilization of liver resections in stage IV colorectal cancer patients with metastases confined to the liver

Lam-Boer

Ali

Verhoeven

et al. 2015

European Journal of Surgical Oncology (EJSO)

View full text Add to dashboard Cite

Section: Discussioncontrasting

confidence: 68%

Large variation in the utilization of liver resections in stage IV colorectal cancer patients with metastases confined to the liver

Lam-Boer

Ali

Verhoeven

et al. 2015

European Journal of Surgical Oncology (EJSO)

View full text Add to dashboard Cite

“…Our results revealed that the mean age at presentation for hepatic-only MCRC was 60.8 years, with a male preponderance. This is comparable to findings in the literature (Al-Sahaf et al, 2009;Ozturk et al, 2010).…”

Section: Discussionsupporting

confidence: 92%

Patterns of Resection among Patients with Hepatic-Only Metastatic Colorectal Cancer a Single Institution Experience and Review

Quintyne¹,

O’Leary²,

O’Kelly³

et al. 2012

American Journal of Immunology

View full text Add to dashboard Cite

Problem statement: Hepatic-only metastasis in colorectal cancer is not a rare clinical finding and can account for 30% of cases. However, only 10-25% of cases are suitable for hepatic resection as part of their treatment pathway. We sought to document our own findings by reviewing patients with hepatic-only disease. Approach: A retrospective analysis was designed to include all patients seen at our institution from 1st January 2000 until 30th June 2010 and information as derived from the patientsï¿½ records. Results: Forty-four (44) patients were found, with an average age of 60.8 years and a male preponderance. The majority of patients (approximately 57%) with hepatic-only metastases developed their disease following adjuvant therapy. Better overall survival was seen when a primary tumor had a low grade of histological differentiation and fewer than 3 hepatic lesions appreciated on conventional radiology. Better outcome was seen in patients who underwent hepatic resection. Conclusion: Patients with hepatic-only metastases are not uncommon within our institution. Hepatic resection afforded better outcome and compares favorably with published literature

show abstract

“…Likewise, post-operative treatment and management of disease recurrence, was not consistent across study centers and limits direct comparisons. To date, studies of CRLM have evaluated time from presentation to definitive diagnosis [32], clinical characteristics and predictors of surgical referral [24, 33, 34] and time related to therapeutic decision making [6, 9, 16]. To our knowledge, ours is the first study to suggest that time from Dx-Rx is significantly associated with OS and propose that longer time intervals from Dx-Rx portend worse OS in patients with best risk resectable CRLM.…”

Section: Discussionmentioning

confidence: 99%

Time-to-Surgery and Survival Outcomes in Resectable Colorectal Liver Metastases: A Multi-Institutional Evaluation

Leal

Bressan

Vachharajani

et al. 2016

Journal of the American College of Surgeons

View full text Add to dashboard Cite

Background Resection of colorectal liver metastases(CRLM) is associated with improved survival; however, the impact of time to resection on survival is unknown. The current multi-institutional study sought to evaluate the influence of time from diagnosis to resection(Dx-Rx) on survival outcomes among patients with resectable, metachronous CRLM and to compare practice patterns across hospitals. Study Design Medical records of patients with ≤ 4 metachronous CRLM treated with surgery were reviewed and analyzed retrospectively. Time from Dx-Rx, was analyzed as a continuous variable and also dichotomized into two groups [Dx-Rx<3 months (Group 1), Dx-Rx≥ 3months (Group 2)] for further analysis. Survival time distributions after resection were estimated using the Kaplan-Meier method. Between group univariate comparisons were based on the log-rank test and multivariable analysis was done using Cox-proportional hazards model. Results From 2000-2010, 626 patients were identified. Type of initial referral(p<0.0001) and use of neoadjuvant(p=0.04) and/or adjuvant (p<0.0001)chemotherapy were significantly different among hospitals. Patients treated with neoadjuvant chemotherapy(n=108) and those with unresectable disease at laparotomy(n=5) were excluded from final evaluation. Median overall(OS) and recurrence free(RFS) survival [median(min-max)] were 74(63.8-84.2)months and 29(23.9-34.1)months, respectively. For the entire cohort, longer time from Dx-Rx was independently associated with shorter OS[Hazard ratio(HR), 95% Confidence Interval(CI)];(HR 1.12, 95% CI 1.06-1.18, p<0.0001) but not RFS. Median OS for Group 1 was 76(62.0-89.2)months vs. 58(34.3-81.7) months in Group 2, p=0.10. Among patients with available data pertaining to adjuvant chemotherapy (n=457; 318 treated, 139 untreated), OS[87(71.2-102.8) vs. 48(25.3-70.7) months, p<0.0001] and RFS[33(25.3-40.7) vs. 22(14.5-29.5) months, p=0.05]were significantly improved. Conclusions In select patients undergoing initial resection for CRLM, longer time from Dx-Rx is independently associated with worse OS. Furthermore, despite uniform disease characteristics, practice patterns related to definitely resectable CRLM vary significantly across hospitals.

show abstract

Referral patterns of patients with liver metastases due to colorectal cancer for resection

Abstract: This study highlights the advanced stage of colorectal cancer at presentation; in light of modern evidence-based, centre-oriented therapy of liver metastasis, we conclude that criteria of referral for resection should be based on the availability of treatment modalities.

Cited by 4 publications

References 20 publications

Large variation in the utilization of liver resections in stage IV colorectal cancer patients with metastases confined to the liver

Large variation in the utilization of liver resections in stage IV colorectal cancer patients with metastases confined to the liver

Patterns of Resection among Patients with Hepatic-Only Metastatic Colorectal Cancer a Single Institution Experience and Review

Time-to-Surgery and Survival Outcomes in Resectable Colorectal Liver Metastases: A Multi-Institutional Evaluation

Contact Info

Product

Resources

About