Relationship between primary colorectal tumour and location of colorectal liver metastases

Pathak, Samir; Palkhi, Ebrahim; Dave, Rajiv; White, Alan; Pandanaboyana, Sanjay; Prasad, K. Raj; Lodge, J. Peter A.; Toogood, Giles J.

doi:10.1111/ans.12767

Cited by 6 publications

(4 citation statements)

References 11 publications

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“…Kuo et al 15 reported a greater incidence of multiple lesions with involvement of multiple segments, large metastatic deposits, and bilobar involvement with higher recurrence rates in centrally located metastasis as compared to peripheral involvement. Together with this, a recent study indicates that there is a statistically significant difference between the involvement of the right and left hepatic lobes with the right lobe being more affected than the left lobe ( P <0.001) 16 . Rhu et al .…”

Section: Discussionsupporting

confidence: 52%

“… 17 also reported greater involvement of the right hepatic lobe in breast carcinoma patients as compared to the left hepatic lobe. A possible explanation for this may be greater anatomical angulation of the left portal vein branch 16 . As a heterogenous neoplasm, breast cancer can differentiate into cells with diverse growth rates and metastatic potential, tumour size, and histological grade, the knowledge of which can have significant therapeutic implications as are provided by a recent study which indicates a remarkable morphological discrepancy in primary and metastatic breast cancer putting forward a possibility for recognition of a better prognosis timely with appropriate management and treatment plans 18 .…”

Section: Discussionmentioning

confidence: 99%

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The tendency of segmental distribution of hepatic metastasis according to couinaud classification: a comparison of portal versus systemic route of metastatis due to primary colorectal and breast tumors

Khan,

Khan

et al. 2023

Annals of Medicine &Amp; Surgery

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Objective: The liver is the commonest site of metastatic disease for patients with colorectal cancer (CRC), with at least 25% of patients developing liver metastasis (LM) during their illness. About 50% of patients diagnosed with metastatic breast cancer develop LM, and 5–12% of these patients develop LM as the main site of breast cancer recurrence. This study aims to determine the frequency of segmental distribution of LM seeding from portal versus systemic routes of dissemination due to primary CRC and breast carcinoma, respectively. Material and methods: This retrospective study was conducted in a tertiary care teaching hospital in Pakistan. Ethical approval was taken from the institutional review board. A total of 587 patients were included in the study with 297 CRC patients with LM and 300 breast carcinoma patients with LM. Segment I involvement was excluded from the calculation because of the dual blood supply. Patients’ detailed demographics and other information were collected on a predesigned proforma. The authors evaluated axial and multiplanar reformatted computed tomography images for LM and CRC metastasis. Data analysis was done using SPSS version 25. P value less than or equal to 0.05 was considered statistically significant. Results: A study population of 587 patients was employed that comprised 287 CRC and 300 breast carcinoma patients. There were 179 (30.5%) male and 408 (69.5%) female patients. The mean age of patients was 54.9±13.3. The study revealed that 204 (34.8%) CRC patients showed right lobe (V, VI, VII, VIII) and 83 (14.1%) CRC patients showed left lobe involvement of metastasis while 192 (32.7%) breast carcinoma patients showed right lobe involvement and 108 (18.4%) breast carcinoma patients showed left lobe involvement in metastasis (P=0.02). We also found 40 (6.8%) colorectal and 55 (9.4%) breast carcinoma patients showed left lateral segment (II, III) involvement. Medial segment involvement (IV) was seen in 43 (7.3%) CRC patients and 53 (9%) breast carcinoma patients (P=0.03). Conclusion: The right hepatic lobe is the predominant site of metastasis independent of the portal or systemic route of dissemination in primary carcinoma. Moreover, in left lobe metastasis medial segment (IV) is more affected in CRC while the lateral segment (II, III) is more affected in breast carcinoma.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

The tendency of segmental distribution of hepatic metastasis according to couinaud classification: a comparison of portal versus systemic route of metastatis due to primary colorectal and breast tumors

Khan,

Khan

et al. 2023

Annals of Medicine &Amp; Surgery

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“…The splenic vein drains flow from the spleen flexure, descending colon, and the rectum, and the superior mesenteric vein drains flow from the transverse and ascending colon. This is referred to as the “streaming” effect of the portal vein [ 39 , 40 ], which has been shown to impact on the distribution of LMs from CRC [ 39 , 41 ]. Thus, we hypothesized that these two explanations may work synergistically to influence the prognosis of patients with CRLMs.…”

Section: Discussionmentioning

confidence: 99%

Does primary tumor location impact the prognosis of colorectal liver metastases patients after microwave ablation? - Lessons from 10 years’ experience

Zhou

Liang

et al. 2017

Oncotarget

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Thermal ablation has been considered as an alternative for local curative intent in patients with unresectable colorectal liver metastases. The influence of primary tumor location on the prognosis of colorectal liver metastases patients who have undergone microwave ablation has yet to be determined. We reviewed 295 patients who underwent microwave ablation for colorectal liver metastases at our institution between March 2006 and March 2016. Univariate and multivariate analyses were performed to identify predictors of overall and progression-free survival. Technical success was achieved in 96.6% of patients (n = 289), with a post-procedural complication rate of 2.0% (n = 6). After a median follow-up of 24 (range, 2–86) months, comparable overall survival rates (p = 0.583) were observed in patients with different primary tumor locations. Patients with colorectal liver metastases originating from left-sided primary colon cancer exhibited a better progression-free survival than patients whose colorectal liver metastases had originated from right-sided primary colon cancer (hazard ratio: 0.67, 95.0% confidence interval: 0.48–0.94; p = 0.012), which was further confirmed in a multivariate analysis after adjustment for other potential prognostic factors. Stratification based on primary tumor location should be taken into consideration in the assessment of disease progression in patients who intend to undergo microwave ablation for colorectal liver metastases.

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“…Available data on the prognostic impact of the CLM hemi-liver location is insufficient, despite many small series reporting poorer prognoses. [25][26][27] The mechanisms of metastatic cancer cell dissemination and implantation are unclear, and no indisputable conclusions can be drawn based on the current knowledge.…”

Section: Left-sided S-clm and Kras Mutationmentioning

confidence: 99%

Is percutaneous destruction of a solitary liver colorectal metastasis as effective as a resection?

Marchese

Seux

Garnier

et al. 2021

Ann Hepatobiliary Pancreat Surg

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Backgrounds/Aims Surgical resection remains the gold standard in the treatment of colorectal liver metastasis. However, when a patient presents with a deep solitary colorectal liver metastasis (S-CLM), the balance between the hepatic volume sacrificed and the S-CLM volume is sometimes clearly unappropriated. Thus, alternatives to surgery, such as operative and percutaneous radiofrequency ablation (RFA) and microwave ablation (MWA), have been developed. This study aimed to identify the prognostic factors affecting survival of patients with S-CLM who undergo curative-intent liver resection or local destruction (RFA or MWA). Methods We retrospectively identified 211 patients with synchronous or metachronous S-CLM who underwent either surgical resection (n=182) or local destruction (RFA or MWA; n=29) according to the S-CLM size, location, and surrounding Glissonian structures. Results Patients who underwent RFA or MWA had S-CLM of a smaller size than those who underwent resection (mean 19.7 vs. 37.3 mm, p <.01). The 1-, 3-, and 5-year overall survival (OS) rates were 97.4%, 84.9%, and 74.9%, respectively. The 1-, 3-, and 5-year disease-free survival (DFS) rates were 77.9%, 47%, and 38.9%, respectively. S-CLM located in the left liver ( p =.04), S-CLM KRAS mutation ( p <.01), and extra-hepatic recurrence ( p <.01) were identified as independent poor risk factors for overall survival (OS); the OS and DFS were comparable in patients with surgical procedure or percutaneous MWA. Conclusions In eligible S-CLM cases, percutaneous MWA seems to be as oncologically efficient as surgical resection and should be include in the decision-tree for treatment strategies.

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Relationship between primary colorectal tumour and location of colorectal liver metastases

Abstract: Right-sided CRLM is more likely regardless of the primary location. Portal streaming may have an effect, although the natural anatomical 'angulation', particularly of the left portal vein branch is more likely to play a role.

Cited by 6 publications

References 11 publications

The tendency of segmental distribution of hepatic metastasis according to couinaud classification: a comparison of portal versus systemic route of metastatis due to primary colorectal and breast tumors

The tendency of segmental distribution of hepatic metastasis according to couinaud classification: a comparison of portal versus systemic route of metastatis due to primary colorectal and breast tumors

Does primary tumor location impact the prognosis of colorectal liver metastases patients after microwave ablation? - Lessons from 10 years’ experience

Is percutaneous destruction of a solitary liver colorectal metastasis as effective as a resection?

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