M J van Amerongen1, E P van der Stok2, J J Fütterer3, S F M Jenniskens4, A Moelker5, C Verhoef2, D J Grünhagen2, J H W de Wilt6. 1. Department of Radiology, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, PO Box: 9101, 6500HB, Nijmegen, the Netherlands. Electronic address: Martin.vanAmerongen@radboudumc.nl. 2. Department of Surgical Oncology, Erasmus MC Cancer Institute Rotterdam, 's Gravendijkwal 230, PO Box: 2040, 3000 CA, Rotterdam, the Netherlands. 3. Department of Radiology, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, PO Box: 9101, 6500HB, Nijmegen, the Netherlands; MIRA Institute for Biomedical Engineering and Technical Medicine, University of Twente, Drienerlolaan 5, PO Box: 217, 7500 AE, Enschede, the Netherlands. 4. Department of Radiology, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, PO Box: 9101, 6500HB, Nijmegen, the Netherlands. 5. Department of Radiology and Nuclear Medicine, Erasmus MC Cancer Institute Rotterdam, 's Gravendijkwal 230, PO Box: 2040, 3000 CA, Rotterdam, the Netherlands. 6. Department of Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, PO Box: 9101, 6500HB, Nijmegen, the Netherlands.
Abstract
BACKGROUND: Approximately 20% of patients with colorectal cancer present with synchronous liver metastases (sCRLM). These patients can be treated with a "one-step procedure" or staged resection, with or without radiofrequency ablation (RFA). Colorectal surgery in combination with intraoperative RFA leads to concerns regarding postoperative complications and survival. The purpose was to evaluate the one-step procedure with or without RFA in patients with sCRLM. MATERIALS AND METHODS: Between January 2000 and September 2018, patients with sCRLM were selected in two tertiary referral centers and retrospectively analyzed. Postoperative morbidity and survival were analyzed. RESULTS: From a total of 410 patients presenting with sCRLM, 329 patients underwent a staged resection and 81 a one-step procedure. The 3-year overall survival (OS) was respectively 66% and 69% for one-step procedure and staged resection (P = 0.24). A total of 18 patients underwent RFA during the one step procedure. No significant differences were shown in postoperative complications whether intraoperative RFA was used in patients with sCRLM. In the one-step procedure, the 3-year OS was respectively 43% and 72% wheter patients did or did not receive RFA (P = 0.19). CONCLUSION: OS for patients with sCRLM was similar for both one-step procedure and staged resection. Intraoperative RFA for sCRLM is technically safe.
BACKGROUND: Approximately 20% of patients with colorectal cancer present with synchronous liver metastases (sCRLM). These patients can be treated with a "one-step procedure" or staged resection, with or without radiofrequency ablation (RFA). Colorectal surgery in combination with intraoperative RFA leads to concerns regarding postoperative complications and survival. The purpose was to evaluate the one-step procedure with or without RFA in patients with sCRLM. MATERIALS AND METHODS: Between January 2000 and September 2018, patients with sCRLM were selected in two tertiary referral centers and retrospectively analyzed. Postoperative morbidity and survival were analyzed. RESULTS: From a total of 410 patients presenting with sCRLM, 329 patients underwent a staged resection and 81 a one-step procedure. The 3-year overall survival (OS) was respectively 66% and 69% for one-step procedure and staged resection (P = 0.24). A total of 18 patients underwent RFA during the one step procedure. No significant differences were shown in postoperative complications whether intraoperative RFA was used in patients with sCRLM. In the one-step procedure, the 3-year OS was respectively 43% and 72% wheter patients did or did not receive RFA (P = 0.19). CONCLUSION: OS for patients with sCRLM was similar for both one-step procedure and staged resection. Intraoperative RFA for sCRLM is technically safe.