IMPORTANCE: Ablative therapies extend the capability of delivering potentially curative treatment for bilateral hepatic colorectal metastases. OBJECTIVE: To compare the long-term effectiveness of ablation with that of resection in patients with bilateral hepatic colorectal metastases. DESIGN: Review of a prospective database of 2123 operative cases of hepatic colorectal metastases. SETTING: A large institution with expertise in ablation and resection. PATIENTS: Patients with bilateral colorectal liver metastases undergoing operation with a curative intent. A total of 141 patients had been treated with bilateral resection (BR) and 95 had undergone ablation. INTERVENTIONS: Radiofrequency or microwave ablation alone or in combination with resection (A/R) compared with BR. MAIN OUTCOMES AND MEASURES: We compared tumor characteristics and operative and postoperative outcomes using χ2 or Wilcoxon tests as appropriate and assessed overall survival differences between the 2 groups using the log-rank test. RESULTS: During the study, 141 patients were treated with BR and 95 patients with A/R. The A/R group was a significantly poorer prognostic group than the BR group as judged by the Clinical Risk Score (P < .01). There was no difference in median operative time (A/R: 280 minutes, BR: 282 minutes; P = .52), but a lower blood loss (A/R: 300 mL, BR: 500 mL; P < .01) and a shorter length of stay (A/R: 7 days, BR: 9 days; P < .01) was achieved in the A/R group. Long-term outcome was not significantly different between the groups (5-year overall survival, A/R: 56%, BR: 49%; P = .16). CONCLUSIONS AND RELEVANCE: Treatment of bilateral, multiple hepatic metastases with combined resection and ablation was associated with improved perioperative outcomes without compromising long-term survival compared with bilateral resection. Ablative therapies extend the capability of delivering potentially curative treatment for bilateral hepatic colorectal metastases.
IMPORTANCE: Ablative therapies extend the capability of delivering potentially curative treatment for bilateral hepatic colorectal metastases. OBJECTIVE: To compare the long-term effectiveness of ablation with that of resection in patients with bilateral hepatic colorectal metastases. DESIGN: Review of a prospective database of 2123 operative cases of hepatic colorectal metastases. SETTING: A large institution with expertise in ablation and resection. PATIENTS: Patients with bilateral colorectal liver metastases undergoing operation with a curative intent. A total of 141 patients had been treated with bilateral resection (BR) and 95 had undergone ablation. INTERVENTIONS: Radiofrequency or microwave ablation alone or in combination with resection (A/R) compared with BR. MAIN OUTCOMES AND MEASURES: We compared tumor characteristics and operative and postoperative outcomes using χ2 or Wilcoxon tests as appropriate and assessed overall survival differences between the 2 groups using the log-rank test. RESULTS: During the study, 141 patients were treated with BR and 95 patients with A/R. The A/R group was a significantly poorer prognostic group than the BR group as judged by the Clinical Risk Score (P < .01). There was no difference in median operative time (A/R: 280 minutes, BR: 282 minutes; P = .52), but a lower blood loss (A/R: 300 mL, BR: 500 mL; P < .01) and a shorter length of stay (A/R: 7 days, BR: 9 days; P < .01) was achieved in the A/R group. Long-term outcome was not significantly different between the groups (5-year overall survival, A/R: 56%, BR: 49%; P = .16). CONCLUSIONS AND RELEVANCE: Treatment of bilateral, multiple hepatic metastases with combined resection and ablation was associated with improved perioperative outcomes without compromising long-term survival compared with bilateral resection. Ablative therapies extend the capability of delivering potentially curative treatment for bilateral hepatic colorectal metastases.
Authors: Peter Kornprat; William R Jarnagin; Mithat Gonen; Ronald P DeMatteo; Yuman Fong; Leslie H Blumgart; Michael D'Angelica Journal: Ann Surg Oncol Date: 2006-12-31 Impact factor: 5.344
Authors: Michael A Choti; James V Sitzmann; Marcelo F Tiburi; Wuthi Sumetchotimetha; Ram Rangsin; Richard D Schulick; Keith D Lillemoe; Charles J Yeo; John L Cameron Journal: Ann Surg Date: 2002-06 Impact factor: 12.969
Authors: Jason S Gold; Chandrakanth Are; Peter Kornprat; William R Jarnagin; Mithat Gönen; Yuman Fong; Ronald P DeMatteo; Leslie H Blumgart; Michael D'Angelica Journal: Ann Surg Date: 2008-01 Impact factor: 12.969
Authors: James S Tomlinson; William R Jarnagin; Ronald P DeMatteo; Yuman Fong; Peter Kornprat; Mithat Gonen; Nancy Kemeny; Murray F Brennan; Leslie H Blumgart; Michael D'Angelica Journal: J Clin Oncol Date: 2007-10-10 Impact factor: 44.544
Authors: Herbert Hurwitz; Louis Fehrenbacher; William Novotny; Thomas Cartwright; John Hainsworth; William Heim; Jordan Berlin; Ari Baron; Susan Griffing; Eric Holmgren; Napoleone Ferrara; Gwen Fyfe; Beth Rogers; Robert Ross; Fairooz Kabbinavar Journal: N Engl J Med Date: 2004-06-03 Impact factor: 91.245
Authors: Eddie K Abdalla; Jean-Nicolas Vauthey; Lee M Ellis; Vickie Ellis; Raphael Pollock; Kristine R Broglio; Kenneth Hess; Steven A Curley Journal: Ann Surg Date: 2004-06 Impact factor: 12.969
Authors: A J Hyde; R Nassabein; A AlShareef; D Armstrong; S Babak; S Berry; D Bossé; E Chen; B Colwell; C Essery; R Goel; R Goodwin; S Gray; N Hammad; A Jeyakuymar; D Jonker; P Karanicolas; N Lamond; R Letourneau; J Michael; N Patil; E Powell; R Ramjeesingh; W Saliba; R Singh; S Snow; T Stuckless; S Tadros; M Tehfé; M Thana; M Thirlwell; M Vickers; K Virik; S Welch; T Asmis Journal: Curr Oncol Date: 2019-10-01 Impact factor: 3.677
Authors: Stefan Stättner; Florian Primavesi; Vincent S Yip; Robert P Jones; Dietmar Öfner; Hassan Z Malik; Stephen W Fenwick; Graeme J Poston Journal: Surg Today Date: 2014-03-16 Impact factor: 2.549
Authors: Afif N Kulaylat; Neil H Bhayani; Audrey L Stokes; Jane R Schubart; Joyce Wong; Eric T Kimchi; Kevin F Staveley-O'Carroll; Jussuf T Kaifi; Niraj J Gusani Journal: J Gastrointest Surg Date: 2014-06-21 Impact factor: 3.452
Authors: U Leung; D Kuk; M I D'Angelica; T P Kingham; P J Allen; R P DeMatteo; W R Jarnagin; Y Fong Journal: Br J Surg Date: 2014-10-09 Impact factor: 6.939