Francesco Esposito1, Chetana Lim1, Antonio Sa Cunha2, Patrick Pessaux3,4, Francis Navarro5, Daniel Azoulay6,7. 1. Department of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, Henri Mondor Hospital, Université Paris-Est (UPEC), 51 Avenue de Lattre de Tassigny, 94010, Créteil, France. 2. Department of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, Paul Brousse Hospital, Villejuif, France. 3. Institut Hospitalo-Universitaire, Institute for Minimally Hybrid Invasive Image-Guided Surgery, Université de Strasbourg, Strasbourg, France. 4. Institut de Recherche sur les Cancers de l'Appareil Digestif (IRCAD), Strasbourg, France. 5. Department of Surgery, Saint-Eloi Hospital, Université de Montpellier, Montpellier, France. 6. Department of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, Henri Mondor Hospital, Université Paris-Est (UPEC), 51 Avenue de Lattre de Tassigny, 94010, Créteil, France. daniel.azoulay@hmn.aphp.fr. 7. INSERM, U955, Créteil, France. daniel.azoulay@hmn.aphp.fr.
Abstract
OBJECTIVES: Multicenter studies comparing the reverse strategy (RS) with the classical strategy (CS) for the management of stage IVA liver-only colorectal cancer (CCR) are scarce. The aim of this study was to compare long-term survival and recurrence patterns following use of the CS and RS. METHOD: This retrospective multicenter review collected data from all consecutive patients with stage IVA liver-only CCR who underwent staged resection of CCR and liver metastases (LM) at 24 French hospitals between 2006 and 2013 and were retrospectively analyzed. Patients who underwent simultaneous liver and CCR resection, those with synchronous extrahepatic metastasis, and those who underwent emergent CCR resection were excluded. Overall survival (OS) and recurrence-free survival (RFS) rates and recurrence patterns were investigated before and after propensity score matching (PSM). RESULTS: A total of 653 patients were included: 587 (89.9%) in the CS group and 66 (10.1%) in the RS group. Compared with the CS patients, RS patients were more likely to have rectal cancer (43.9 vs. 24.9%; p = 0.006), larger liver tumor size (52.5 ± 38.6 vs. 39.6 ± 30 mm; p = 0.01), and more positive lymph nodes (62.1 vs. 44.8%; p = 0.009). OS was not different between the two groups (75 vs. 72% at 5 years; p = 0.77), while RFS was worse in the RS group (24 vs. 33% at 5 years; p = 0.01). Time to recurrence at any site (1.8 vs. 2.4 years, p = 0.024) and intrahepatic recurrence (1.7 vs. 2.2 years, p = 0.014) were significantly shorter in the RS group than in the CS group. After PSM (63 patients in each group), no significant difference was found between the two groups in OS (p = 0.35), RFS (p = 0.62), time to recurrence at any site (p = 0.19), or intrahepatic recurrence (p = 0.13). CONCLUSIONS: In this study, approximately 10% of patients with CCR and synchronous LM were offered surgery with the RS. Both strategies ensured similar oncological outcomes.
OBJECTIVES: Multicenter studies comparing the reverse strategy (RS) with the classical strategy (CS) for the management of stage IVA liver-only colorectal cancer (CCR) are scarce. The aim of this study was to compare long-term survival and recurrence patterns following use of the CS and RS. METHOD: This retrospective multicenter review collected data from all consecutive patients with stage IVA liver-only CCR who underwent staged resection of CCR and liver metastases (LM) at 24 French hospitals between 2006 and 2013 and were retrospectively analyzed. Patients who underwent simultaneous liver and CCR resection, those with synchronous extrahepatic metastasis, and those who underwent emergent CCR resection were excluded. Overall survival (OS) and recurrence-free survival (RFS) rates and recurrence patterns were investigated before and after propensity score matching (PSM). RESULTS: A total of 653 patients were included: 587 (89.9%) in the CS group and 66 (10.1%) in the RS group. Compared with the CSpatients, RSpatients were more likely to have rectal cancer (43.9 vs. 24.9%; p = 0.006), larger liver tumor size (52.5 ± 38.6 vs. 39.6 ± 30 mm; p = 0.01), and more positive lymph nodes (62.1 vs. 44.8%; p = 0.009). OS was not different between the two groups (75 vs. 72% at 5 years; p = 0.77), while RFS was worse in the RS group (24 vs. 33% at 5 years; p = 0.01). Time to recurrence at any site (1.8 vs. 2.4 years, p = 0.024) and intrahepatic recurrence (1.7 vs. 2.2 years, p = 0.014) were significantly shorter in the RS group than in the CS group. After PSM (63 patients in each group), no significant difference was found between the two groups in OS (p = 0.35), RFS (p = 0.62), time to recurrence at any site (p = 0.19), or intrahepatic recurrence (p = 0.13). CONCLUSIONS: In this study, approximately 10% of patients with CCR and synchronous LM were offered surgery with the RS. Both strategies ensured similar oncological outcomes.
Authors: J Hallet; A Sa Cunha; R Adam; D Goéré; P Bachellier; D Azoulay; A Ayav; E Grégoire; F Navarro; P Pessaux Journal: Br J Surg Date: 2016-06-16 Impact factor: 6.939
Authors: Christian Sturesson; Valentinus T Valdimarsson; Erik Blomstrand; Sam Eriksson; Jan H Nilsson; Ingvar Syk; Gert Lindell Journal: HPB (Oxford) Date: 2016-11-09 Impact factor: 3.647
Authors: Eric Van Cutsem; Bernard Nordlinger; Rene Adam; Claus-Henning Köhne; Carmelo Pozzo; Graeme Poston; Marc Ychou; Philippe Rougier Journal: Eur J Cancer Date: 2006-08-10 Impact factor: 9.162
Authors: Felice Giuliante; Luca Viganò; Agostino M De Rose; Darius F Mirza; Réal Lapointe; Gernot Kaiser; Eduardo Barroso; Alessandro Ferrero; Helena Isoniemi; Santiago Lopez-Ben; Irinel Popescu; Jean-Francois Ouellet; Catherine Hubert; Jean-Marc Regimbeau; Jen-Kou Lin; Oleg G Skipenko; Francesco Ardito; René Adam Journal: Ann Surg Oncol Date: 2021-07-01 Impact factor: 5.344