Rui Ma1, Tao Li2. 1. Department of Critical Medicine, Peking University People's Hospital No. 11 Xizhimen South Street, West District, Beijing 100044, P. R. China. 2. Department of Hepatobiliary Surgery, Peking University People's Hospital No. 11 Xizhimen South Street, West District, Beijing 100044, P. R. China.
Abstract
OBJECTIVE: To explore surgical treatment strategies for patients with liver metastases from colorectal cancer (CRLM), and analyze the prognosis and influencing factors. METHODS: The clinical data of 156 inpatients with CRLM admitted to our hospital from January 2009 to June 2019 were retrospectively analyzed. Patients were divided into initially resectable group (80 cases) and initially unresectable group (76 cases). For patients with initially unresectable CRLM, conversion therapy (chemotherapy plus targeted therapy) combined with individualized surgical treatment strategy was used. The individualized surgical treatment strategy mainly included hepatectomy combined with ablation. Portal vein ligation and staged resection were adopted according to the patients' specific conditions. All patients were followed up until death. The Kaplan-Meier method and Log-rank test were used for survival analysis. RESULTS: Median overall survival (OS) time of patients in the initially resectable group and initially unresectable group were 36 months and 17 months, respectively (P = 0.001). Median OS time of 24 patients who underwent surgical resection after successful conversion therapy was significantly longer than that of 52 patients with unsuccessful conversion therapy (20 months versus 15 months, respectively, P = 0.034). Univariate analysis showed that a maximum diameter of liver metastases < 6 cm and a number of metastases ≤ 4 were independent factors associated with successful conversion therapy. According to patients' specific conditions, 6 cases accepted hepatectomy combined with ablation, and 1 case accepted portal vein ligation and staged resection. CONCLUSION: Treatment of patients with CRLM should follow the principles of standardization and individualization. For patients with initially unresectable CRLM, successful conversion therapy should be pursued whenever possible. The maximum size and number of liver metastases were significantly associated with successful conversion therapy. Surgical resection-based comprehensive treatment is key. IJCEP
OBJECTIVE: To explore surgical treatment strategies for patients with liver metastases from colorectal cancer (CRLM), and analyze the prognosis and influencing factors. METHODS: The clinical data of 156 inpatients with CRLM admitted to our hospital from January 2009 to June 2019 were retrospectively analyzed. Patients were divided into initially resectable group (80 cases) and initially unresectable group (76 cases). For patients with initially unresectable CRLM, conversion therapy (chemotherapy plus targeted therapy) combined with individualized surgical treatment strategy was used. The individualized surgical treatment strategy mainly included hepatectomy combined with ablation. Portal vein ligation and staged resection were adopted according to the patients' specific conditions. All patients were followed up until death. The Kaplan-Meier method and Log-rank test were used for survival analysis. RESULTS: Median overall survival (OS) time of patients in the initially resectable group and initially unresectable group were 36 months and 17 months, respectively (P = 0.001). Median OS time of 24 patients who underwent surgical resection after successful conversion therapy was significantly longer than that of 52 patients with unsuccessful conversion therapy (20 months versus 15 months, respectively, P = 0.034). Univariate analysis showed that a maximum diameter of liver metastases < 6 cm and a number of metastases ≤ 4 were independent factors associated with successful conversion therapy. According to patients' specific conditions, 6 cases accepted hepatectomy combined with ablation, and 1 case accepted portal vein ligation and staged resection. CONCLUSION: Treatment of patients with CRLM should follow the principles of standardization and individualization. For patients with initially unresectable CRLM, successful conversion therapy should be pursued whenever possible. The maximum size and number of liver metastases were significantly associated with successful conversion therapy. Surgical resection-based comprehensive treatment is key. IJCEP
Authors: M J van Amerongen; E P van der Stok; J J Fütterer; S F M Jenniskens; A Moelker; D J Grünhagen; C Verhoef; J H W de Wilt Journal: Eur J Surg Oncol Date: 2016-01-23 Impact factor: 4.424
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Authors: Héber Salvador de Castro Ribeiro; Orlando Jorge Martins Torres; Márcio Carmona Marques; Paulo Herman; Antonio Nocchi Kalil; Eduardo de Souza Martins Fernandes; Fábio Ferreira de Oliveira; Leonaldson Dos Santos Castro; Rodrigo Hanriot; Suilane Coelho Ribeiro Oliveira; Marcio Fernando Boff; Wilson Luiz da Costa; Roberto de Almeida Gil; Tulio Eduardo Flesch Pfiffer; Fabio Ferrari Makdissi; Manoel de Souza Rocha; Paulo Cezar Galvão do Amaral; Leonardo Atem Gonçalves de Araújo Costa; Tomas A Aloia Journal: Arq Bras Cir Dig Date: 2016-03