Survival after Liver Resection for Metastatic Colorectal Carcinoma in a Large Population

Shah, Shimul A.; Bromberg, Rudy; Coates, Angela; Rempel, Eddy; Šimunović, Marko; Gallinger, Steven

doi:10.1016/j.jamcollsurg.2007.06.283

Cited by 104 publications

(64 citation statements)

References 39 publications

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“…[1][2][3][4][5] Although careful patient selection, improved operative technique, and more developed perioperative care pathways have resulted in decreased perioperative morbidity and mortality following liver resection, a significant proportion of patients presenting with hepatocellular carcinoma (HCC), colorectal liver metastasis (CRLM) or biliary malignancies are not candidates for curative resection due to inadequate functional hepatic reserve, multifocal disease or a combination of both. 3,[6][7][8][9] For patients who are not candidates for surgical resection due to multifocal disease, adjunct locoregional therapies including the concurrent use of thermal or alcohol ablation has been proposed.…”

Section: Introductionmentioning

confidence: 99%

Patterns of hepatic resections in North America: use of concurrent partial resections and ablations

Gani

Thompson

Bentrem

et al. 2016

HPB

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Section: Introductionmentioning

confidence: 99%

Patterns of hepatic resections in North America: use of concurrent partial resections and ablations

Gani

Thompson

Bentrem

et al. 2016

HPB

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“…In an "oligo-metastatic" scenario (patients with single or limited metastases), local therapies may improve overall survival. 1 For colorectal liver metastases, resection series have yielded 5-year survival rates of 50-60%, 2 leading to a cure of selected cases. However, most patients with liver metastases are unfit for surgery because of unfavorable tumor factors or their poor general conditions, and treatment strategies focusing on effective local treatment may be indicated after proper patient selection.…”

Section: Introductionmentioning

confidence: 99%

Image guided SBRT for multiple liver metastases with ExacTrac® Adaptive Gating

Rubio

Hernando-Requejo

Aparicio

et al. 2017

Reports of Practical Oncology & Radiotherapy

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“…Despite those advances, liver resection is the treatment that is most effective in achieving longterm survival and offering the possibility of cure in stage iv disease confined to the liver 4,5 . Patients with R0 resection of liver metastases have a 5-year survival rate of approximately 45% and a 10-year overall survival rate of 25% 4,5,[8][9][10][11][12] . Because only a proportion of patients with crc metastatic disease are considered for liver resection, and because management of this patient population is complex, multidisciplinary management is required.…”

Section: Introductionmentioning

confidence: 99%

Liver Resection for Colorectal Cancer Metastases

et al. 2013

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These recommendations apply to patients with liver metastases from crc who have had or will have a complete (R0) resection of the primary cancer and who are being considered for resection of the liver, or liver plus specific and limited ehms, with curative intent. 1(a). Patients with liver and lung metastases should be seen in consultation with a thoracic surgeon. Combined or staged metastasectomy is recommended when, taking into account anatomic and physiologic considerations, the assessment is that all pulmonary metastases can also be completely removed. Furthermore, liver resection may be indicated in patients who have had a prior lung resection, and vice versa. 1(b). Routine liver resection is not recommended in patients with portal nodal disease. This group includes patients with radiologically suspicious portal nodes or malignant portal nodes found preoperatively or intraoperatively. Liver plus nodal resection, together with perioperative systemic therapy, may be an option-after a full discussion with the patient-in cases with limited nodal involvement and with metastases that can be completely resected. 1(c). Routine liver resection is not recommended in patients with nonpulmonary ehms. Liver plus extrahepatic resection, together with perioperative systemic therapy, may be an option-after a full discussion with the patient-for metastases that can be completely resected. 2(a). Perioperative chemotherapy, either before and after resection, or after resection, is recommended in patients with resectable ABSTRACT Questions1. Should surgery be considered for colorectal cancer (crc) patients who have liver metastases plus (a) pulmonary metastases, (b) portal nodal disease, or (c) other extrahepatic metastases (ehms)? 2. What is the role of chemotherapy in the surgical management of crc with liver metastases in (a) patients with resectable disease in the liver, or (b) patients with initially unresectable disease in the liver that is downsized with chemotherapy ("conversion")? 3. What is the role of liver resection when one or more crc liver metastases have radiographic complete response (rcr) after chemotherapy? PerspectivesAdvances in chemotherapy have improved survival in crc patients with liver metastases. The 5-year survival with chemotherapy alone is typically less than 1%, although two recent studies with folfox or folfoxiri (or both) reported rates of 5%-10%. However, liver resection is the treatment that is most effective in achieving long-term survival and offering the possibility of a cure in stage iv crc patients with liver metastases. This guideline deals with the role of chemotherapy with surgery, and the role of surgery when there are liver metastases plus ehms. Because only a proportion of patients with crc metastatic disease are considered for liver resection, and because management of this patient population is complex, multidisciplinary management is required. MethodologyRecommendations in the present guideline were formulated based on a prepublication version of a recent systematic review on th...

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Survival after Liver Resection for Metastatic Colorectal Carcinoma in a Large Population

Cited by 104 publications

References 39 publications

Patterns of hepatic resections in North America: use of concurrent partial resections and ablations

Patterns of hepatic resections in North America: use of concurrent partial resections and ablations

Image guided SBRT for multiple liver metastases with ExacTrac® Adaptive Gating

Liver Resection for Colorectal Cancer Metastases

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