Treatment strategies and outcome of surgery for synchronous colorectal liver metastases

Reding, Daniel; Paulweber, Bernhard; Breitenstein, Stefan; Stupp, Roger; Clavien, Pierre‐Alain; Slankamenac, Ksenija; Samaras, Panagiotis

doi:10.4414/smw.2017.14486

Cited by 7 publications

(6 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…When OLR is compared to LLR for CRLM, 5-yr OS has been found to not be significantly different, with 63% after OLR and 54% after LLR, with a 5-yr RFS of 38% and 36%, respectively [ 38 ]. When only synchronous CRLMs are analyzed, the reported 5-year OS decreases to 25.5–41.1% with a 5-yr RFS of 16.8% [ 39 , 40 ], and 3-year survival ranges from 47–58%, which is consistent with our results [ 41 ]. Up to one-third of patients alive at 5 years will ultimately succumb to recurrent disease; because of this, 10-year survival may be a better indicator of cure in patients with CRLM [ 28 ].…”

Section: Discussionsupporting

confidence: 91%

Survival Study: International Multicentric Minimally Invasive Liver Resection for Colorectal Liver Metastases (SIMMILR-2)

Gumbs

Croner

Lorenz

et al. 2022

Cancers

View full text Add to dashboard Cite

Introduction: Study: International Multicentric Minimally Invasive Liver Resection for Colorectal Liver Metastases (SIMMILR-CRLM) was a propensity score matched (PSM) study that reported short-term outcomes of patients with CRLM who met the Milan criteria and underwent either open (OLR), laparoscopic (LLR) or robotic liver resection (RLR). This study, designated as SIMMILR-2, reports the long-term outcomes from that initial study, now referred to as SIMMILR-1. Methods: Data regarding neoadjuvant chemotherapeutic (NC) and neoadjuvant biological (NB) treatments received were collected, and Kaplan–Meier curves reporting the 5-year overall (OS) and recurrence-free survival (RFS) for OLR, LLR and RLR were created for patients who presented with synchronous lesions only, as there was insufficient follow-up for patients with metachronous lesions. Results: A total of 73% of patients received NC and 38% received NB in the OLR group compared to 70% and 28% in the LLR group, respectively (p = 0.5 and p = 0.08). A total of 82% of patients received NC and 40% received NB in the OLR group compared to 86% and 32% in the RLR group, respectively (p > 0.05). A total of 71% of patients received NC and 53% received NB in the LLR group compared to 71% and 47% in the RLR group, respectively (p > 0.05). OS at 5 years was 34.8% after OLR compared to 37.1% after LLR (p = 0.4), 34.3% after OLR compared to 46.9% after RLR (p = 0.4) and 30.3% after LLR compared to 46.9% after RLR (p = 0.9). RFS at 5 years was 12.1% after OLR compared to 20.7% after LLR (p = 0.6), 33.3% after OLR compared to 26.3% after RLR (p = 0.6) and 22.7% after LLR compared to 34.6% after RLR (p = 0.6). Conclusions: When comparing OLR, LLR and RLR, the OS and RFS were all similar after utilization of the Milan criteria and PSM. Biological agents tended to be utilized more in the OLR group when compared to the LLR group, suggesting that highly aggressive tumors are still managed through an open approach.

show abstract

Section: Discussionsupporting

confidence: 91%

Survival Study: International Multicentric Minimally Invasive Liver Resection for Colorectal Liver Metastases (SIMMILR-2)

Gumbs

Croner

Lorenz

et al. 2022

Cancers

View full text Add to dashboard Cite

show abstract

“…The reported median OS was 3.5 years, which is obviously closer to our results, with an OS of 3.3 years. Similar result are presented [17] with OS of 2.8 years in 109 patients with synchronous liver metastasis after liver resection. This finding indicates that there is a larger negative prognostic importance for synchronicity of the metastases and the primary tumour with respect to OS than simultaneously detected liver and lung metastases.…”

Section: Discussionsupporting

confidence: 87%

“…HNPCC was not present in our cohort. Median hospital stay was 11 (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) days. There was no 30-day mortality.…”

Section: Primary Tumourmentioning

confidence: 99%

Outcome of Radical Surgery for Simultaneous Liver and Lung Metastases Synchronous with Primary Colorectal Cancer

et al. 2021

View full text Add to dashboard Cite

Background Colorectal cancer (CRC) leads to metastatic disease in approximately 30% of patients. In patients with newly diagnosed CRC with both liver and lung metastases, curative resection is rarely possible. The aim of this study is to evaluate the overall (OS) and relapse-free survival (RFS) rates of these patients after resection with curative intent. Methods This study is a retrospective analysis of colorectal cancer patients (n=8, median age 54.3 years) with simultaneous liver and lung metastasis undergoing resection with curative intent between May 1st, 2002, to December 31st, 2016, at our institution. Results Colon was the primary tumour site in 2 patients and rectum in 6 patients. The median number of liver and lung metastases was 3 and 2, respectively. Patients received various treatment sequences individualized on tumour disease burden. R0 resection was achieved after all but one procedure. Two severe Clavien-Dindo grade IIIb complications were present. Median hospital stay was 9 (3–24) days per procedure. Tumour relapse was observed in all patients with median RFS of 9 (3–28) months and median OS of 40 (17–52) months. In 4 cases, where repeated resection of recurrent metastases (3 liver and 1 lung) was possible, the median OS was 43 months. Conclusion Our data suggests that patients seem to benefit from resection with curative intent, with tendency to prolonged OS and with acceptable complication rate. Tumour recurrence occurred in all patients. Repeated resection was beneficial and led to further prolonged OS.

show abstract

“…All 12 included studies [24][25][26][27][28][29][30][31][32][33][34][35] were retrospective cohort studies, and no randomised controlled trial was performed. Most of the included studies were conducted in Europe, with two studies from the United States and one study from Japan.…”

Section: Selection Of Trials and Patient Characteristicsmentioning

confidence: 99%

Evaluating the outcomes of liver‐first approach for liver metastases due to colorectal cancer: A systematic review and meta‐analysis

et al. 2022

View full text Add to dashboard Cite

Purpose Surgery is the mainstay treatment for colorectal cancer and offers a long‐term survival benefit for patients with liver metastases; however, the appropriate approach remains debatable. We aimed to systematically review and perform a meta‐analysis of liver‐first and classical (colon‐first) approaches. Methods The following electronic databases were searched for systematic literature: PubMed and the Cochrane Library. Studies that compared patients with liver metastases due to colorectal cancer and who underwent liver‐first and classical resections were selected. Primary outcomes were long‐term overall survival and disease‐free survival, and secondary outcomes were perioperative morbidity and mortality. Results Over 12 studies with 6344 patients were analysed; of the total patients, 1141 and 4552 underwent liver‐first resection and classical resection, respectively. The meta‐analysis showed no significant difference between the liver‐first resection group and classical resection group in terms of overall morbidity (risk ratio [RR] 1.26, 95% confidence interval [CI] 0.91‐1.74) and 90‐day mortality (RR 1.26, 95% CI 0.52‐3.04, P = .23). The classical resection group showed favourable overall survival and disease‐free survival than the liver‐first resection group in the nonpropensity score‐matched studies (RR 1.19, 95% CI 1.09‐1.3) but showed comparable results in the propensity score‐matched studies (RR 1.07, 95% CI 0.97‐1.18). Conclusions The perioperative and long‐term outcomes of the liver‐first and classical approaches were comparable. Selection of the appropriate approach that will be used for a patient depends on the characteristics of the primary colorectal tumour and the occurrence of liver metastases.

show abstract

Treatment strategies and outcome of surgery for synchronous colorectal liver metastases

Cited by 7 publications

References 28 publications

Survival Study: International Multicentric Minimally Invasive Liver Resection for Colorectal Liver Metastases (SIMMILR-2)

Survival Study: International Multicentric Minimally Invasive Liver Resection for Colorectal Liver Metastases (SIMMILR-2)

Outcome of Radical Surgery for Simultaneous Liver and Lung Metastases Synchronous with Primary Colorectal Cancer

Evaluating the outcomes of liver‐first approach for liver metastases due to colorectal cancer: A systematic review and meta‐analysis

Contact Info

Product

Resources

About