Short- and long-term outcomes of surgery for colorectal and non-colorectal liver metastasis: a report from a single center in the Baltic country

Abstract

Background: The liver is a major target organ for metastases of various types of cancers. Surgery is a wellestablished option for colorectal liver metastases (CRLM). Regarding the improved surgical and anesthetic techniques, the safety of liver resection has increased. Consequently, the interest in the surgical management of non-colorectal liver metastases (non-CRLM) has gained significant attention. Therefore, this study was designed to investigate the surgical treatment outcomes for non-CRLM and to compare it with an outcome of CRLM in a tertiary care center in the Baltic country-Lithuania. Methods: We retrospectively analyzed data from all patients who underwent liver resection for CRLM or non-CRLM between 2010 and 2017 in a tertiary care center-Vilnius University hospital Santaros Clinics. Demographic and metastasis characteristics, as well as disease-free and overall survival, were compared between the study groups. Results: In total, 149 patients were included in the study. Patients in the CRLM group were older (63.2 ± 1.01 vs 54.1 ± 1.8 years, p < 0.001) and mainly predominant by males. Overall postoperative morbidity rate (16.3% vs 9.8%, p = 0.402) and major complications rate (10% vs 7.8%, p = 0.704) after liver resection for CRLM and non-CRLM was similar. Kaplan-Meier analysis showed higher disease-free survival in the CRLM group with 89.4% vs 76.5% and 64.9% vs 31.4% survival rates at 1 and 3 years, respectively (p = 0.042), although overall survival was not different between the CRLM and non-CRLM groups with 89.4% vs 78.4% and 72.0% vs 46.1% survival rates at 1 and 3 years, respectively (p = 0.300). Conclusions: In this study, we confirmed comparable short-and long-term outcomes after liver resection for CRLM and non-CRLM. Surgical resection should be encouraged as an option in well-selected patients with non-CRLM.

Indocyanine Green Fluorescence Navigation in Liver Surgery

“…In the last decades, liver surgery has dramatically developed, becoming a standardized and safe operation with perioperative mortality rates 1.0% and 2.0% even for advanced laparoscopic and open liver resections, respectively 1 . Improvements in preoperative evaluation, patient selection, advances in surgical technique and technology are the main reasons of this enhancement 2,3 . The cornerstone for a successful oncologic liver surgery relies on obtaining a R0 resection margin and preserving a proper healthy liver parenchyma to achieve better short- and long- term outcomes 4,5 .…”

“…1 Improvements in preoperative evaluation, patient selection, advances in surgical technique and technology are the main reasons of this enhancement. 2,3 The cornerstone for a successful oncologic liver surgery relies on obtaining a R0 resection margin and preserving a proper healthy liver parenchyma to achieve better short-and long-term outcomes. 4,5 To achieve these goals, the application of intraoperative navigation tools has been required as a part of the progressive developments in liver surgery.…”

Nomogram for predicting occurrence of synchronous liver metastasis in colorectal cancer: a single-center retrospective study based on pathological factors

“…In addition, for high-risk patients, positron emission tomography computed tomography (PET-CT) and invasive procedures such as needle biopsy are also recommended for definite diagnosis if there is an undefined low-density liver lesion, because they are expensive and are not justified for general screening. If a positive liver result is found in a targeted examination, we can change the treatment plan in time so as not to delay the disease such as radiofrequency ablation and surgery [ 34 – 36 ]. Of course, this study only provides a reference rather than a guide, and specific decisions should be made based on clinical practice.…”

Development and validation of prognostic nomograms for patients with colon neuroendocrine neoplasms

“…Patients have a slightly better prognosis if they do not have metastatic disease, if they have an adenocarcinoma component within the tumor, or if they respond to chemotherapy [ 23 ]. Unlike patients with non-colorectal non-neuroendocrine liver metastases [ 24 – 26 ], surgery, especially in the presence of metastatic disease, may not provide any survival benefit for most patients [ 23 ]. Fields et al [ 27 ] demonstrated that the total number of positive lymph nodes was an independent predictor of survival in patients with colon NENs.…”