scholarly journals P-175 Effectiveness, prognostic factors and safety concerning ablative techniques in liver metastases from gastrointestinal tumors

2021 ◽  
Vol 32 ◽  
pp. S159-S160
Author(s):  
M. Gomez-Randulfe Rodriguez ◽  
B. Alonso de Castro ◽  
E. Castro Lopez ◽  
M. Maestro Duran ◽  
S. Silva Diaz ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Liver Metastases ◽  
Gastrointestinal Tumors ◽  
Ablative Techniques

scholarly journals Efficacy of Surgery for the Treatment of Gastric Cancer Liver Metastases: A Systematic Review of the Literature and Meta-Analysis of Prognostic Factors

2021 ◽  
Vol 10 (5) ◽  
pp. 1141
Author(s):  
Gianpaolo Marte ◽  
Andrea Tufo ◽  
Francesca Steccanella ◽  
Ester Marra ◽  
Piera Federico ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Systematic Review ◽  
Prognostic Factors ◽  
Liver Metastases ◽  
Meta Analysis ◽  
Multidisciplinary Treatment ◽  
Review Of The Literature ◽  
Term Survival ◽  
The Impact

Background: In the last 10 years, the management of patients with gastric cancer liver metastases (GCLM) has changed from chemotherapy alone, towards a multidisciplinary treatment with liver surgery playing a leading role. The aim of this systematic review and meta-analysis is to assess the efficacy of hepatectomy for GCLM and to analyze the impact of related prognostic factors on long-term outcomes. Methods: The databases PubMed (Medline), EMBASE, and Google Scholar were searched for relevant articles from January 2010 to September 2020. We included prospective and retrospective studies that reported the outcomes after hepatectomy for GCLM. A systematic review of the literature and meta-analysis of prognostic factors was performed. Results: We included 40 studies, including 1573 participants who underwent hepatic resection for GCLM. Post-operative morbidity and 30-day mortality rates were 24.7% and 1.6%, respectively. One-year, 3-years, and 5-years overall survival (OS) were 72%, 37%, and 26%, respectively. The 1-year, 3-years, and 5-years disease-free survival (DFS) were 44%, 24%, and 22%, respectively. Well-moderately differentiated tumors, pT1–2 and pN0–1 adenocarcinoma, R0 resection, the presence of solitary metastasis, unilobar metastases, metachronous metastasis, and chemotherapy were all strongly positively associated to better OS and DFS. Conclusion: In the present study, we demonstrated that hepatectomy for GCLM is feasible and provides benefits in terms of long-term survival. Identification of patient subgroups that could benefit from surgical treatment is mandatory in a multidisciplinary setting.

scholarly journals The lack of selection criteria for surgery in patients with non-colorectal non-neuroendocrine liver metastases

2020 ◽  
Author(s):  
Ali Bohlok ◽  
Valerio Lucidi ◽  
Fikri Bouazza ◽  
Ali Daher ◽  
Desislava Germanova ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Liver Metastases ◽  
Selection Criteria ◽  
Disease Free Survival ◽  
Population Level ◽  
Survival Group ◽  
Term Survival ◽  
Clinicopathologic Parameters ◽  
Therapeutic Decision Making ◽  
Neuroendocrine Liver Metastases

Abstract Background: The benefit of surgery in patients with non-colorectal non-neuroendocrine liver metastases (NCRNNELM) remains controversial. At the population level, several statistical prognostic factors and scores have been proposed but inconsistently verified. At the patient level, no selection criteria have been demonstrated to guide individual therapeutic decision making. We aimed to evaluate potential individual selection criteria to predict the benefit of surgery in patients undergoing treatment for NCRNNELM.Methods: Data for 114 patients undergoing surgery for NCRNNELM were reviewed. In this population, we identified an early relapse group (ER), defined as patients with unresectable recurrence <1 year postoperatively who did not benefit from surgery (N=28), and a long-term survival group (LTS), defined as patients who were recurrence-free ≥5-years postoperatively and benefited from surgery (N=20). Clinicopathologic parameters, the Association Française de Chirurgie (AFC) score, and a modified 4-point Clinical Risk Score (mCRS) (excluding CEA level) were analyzed and compared between LTS and ER groups.Results: The majority of patients were female and a majority had an ASA score ≤2 at the time of liver surgery. Median age was 55 years. Almost half of the patients (46%) presented with a single liver metastasis. Intermediate- and low-risk AFC scores represented 40% and 60% of the population, respectively. Five- and ten-year overall survival (OS) and disease-free survival (DFS) rates were 56% and 27%, and 30% and 12%, respectively. Negative prognostic factors were size of liver metastases >50 mm and delay between primary and NCRNNELM <24 months for OS and DFS, respectively. AFC score was not prognostic while high-risk mCRS (score 3-4) was predictive for poorer OS. The clinicopathologic parameters were similar in the ER and LTS groups, except the presence of N+ primary tumor and the size of liver metastases were significantly higher in the ER group. Conclusion: In patients with resectable NCRNNELM, no predictive factors or scores were found to accurately preoperatively differentiate individual cases in whom surgery would be futile from those in whom surgery could be associated with a significant oncological benefit.

scholarly journals Perioperative Tumour Marker Levels as Prognostic Factors for Surgical Treatment of Breast Cancer Liver Metastases

2018 ◽  
Vol 38 (6) ◽  
pp. 3647-3652
Author(s):  
VLADISLAV TRESKA ◽  
ONDREJ TOPOLCAN ◽  
VERA ZOUBKOVA ◽  
INKA TRESKOVA ◽  
ANDREA NARSANSKA ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Surgical Treatment ◽  
Liver Metastases ◽  
Tumour Marker ◽  
Breast Cancer Liver Metastases

scholarly journals Prognostic factors after hepatectomy for liver metastases of non-colorectal and non-neuroendocrine cancer: single center experience

HPB ◽  
2018 ◽  
Vol 20 ◽  
pp. S349-S350
Author(s):  
E. Santos ◽  
H. Alexandrino ◽  
L. Ferreira ◽  
R. Nemésio ◽  
R. Martins ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Liver Metastases ◽  
Single Center ◽  
Neuroendocrine Cancer ◽  
Single Center Experience

Is Hepatic Resection Justified After Chemotherapy in Patients With Colorectal Liver Metastases and Lymph Node Involvement?

2008 ◽  
Vol 26 (22) ◽  
pp. 3672-3680 ◽  
Author(s):  
René Adam ◽  
Robbert J. de Haas ◽  
Dennis A. Wicherts ◽  
Thomas A. Aloia ◽  
Valérie Delvart ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Liver Metastases ◽  
Preoperative Chemotherapy ◽  
Colorectal Liver Metastases ◽  
Regional Lymph Node ◽  
Young Patients ◽  
Disease Free Survival ◽  
High Risk Group

Purpose For patients with colorectal liver metastases (CLM), regional lymph node (RLN) involvement is one of the worst prognostic factors. The objective of this study was to evaluate the ability of a multidisciplinary approach, including preoperative chemotherapy and hepatectomy, to improve patient outcomes. Patients and Methods Outcomes for a consecutively treated group of patients with CLM and simultaneous RLN involvement were compared with a cohort of patients without RLN involvement. Univariate and multivariate analysis of clinical variables was used to identify prognostic factors in this high-risk group. Results Of the 763 patients who underwent resection at our institution for CLM between 1992 and 2006, 47 patients (6%) were treated with hepatectomy and simultaneous lymphadenectomy. All patients had received preoperative chemotherapy. Five-year overall survival (OS) for patients with and without RLN involvement were 18% and 53%, respectively (P < .001). Five-year disease-free survival rates were 11% and 23%, respectively (P = .004). When diagnosed preoperatively, RLN involvement had an increased 5-year OS compared with intraoperative detection, although the difference was not significant (35% v 10%; P = .18). Location of metastatic RLN strongly influenced survival, with observed 5-year OS of 25% for pedicular, 0% for celiac, and 0% for para-aortic RLN (P = .001). At multivariate analysis, celiac RLN involvement and age ≥ 40 years were identified as independent poor prognostic factors. Conclusion Combined liver resection and pedicular lymphadenectomy is justified when RLN metastases respond to or are stabilized by preoperative chemotherapy, particularly in young patients. In contrast, this approach does not benefit patients with celiac and/or para-aortic RLN involvement, even when patients’ disease is responding to preoperative chemotherapy.

Patterns and prognostic factors of malignant ascites in hospitalized patients with advanced stage cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24141-e24141
Author(s):  
Shanila Ahmed ◽  
Mir Ibrahim Sajid ◽  
Risha Fayyaz ◽  
Faiza Ilyas ◽  
Noreen Nasir
Keyword(s):  
Ovarian Cancer ◽  
Abdominal Pain ◽  
Prognostic Factors ◽  
Serum Albumin ◽  
Liver Metastases ◽  
Malignant Ascites ◽  
Baseline Characteristic ◽  
Cancer Type ◽  
Advanced Stage ◽  
Low Serum

e24141 Background: Ascites is a shared pathological manifestation of numerous diseases, the primary (81%) disease being hepatic cirrhosis. Ascites is termed “malignant” when it is associated with cancers. It can manifest as abdominal swelling, abdominal pain, nausea and vomiting, anorexia and fatigue. Our study aimed at identifying baseline characteristic in patients who present to our hospital with malignant ascites as the first sign of advanced stage cancers and the factors that can affect outcomes in such patients. Methods: This is a retrospective study which includes all the patients who had been diagnosed with malignant ascites at our institute between the years 2012 and 2016.The diagnosis was made either on the basis of cytological examination or medical imaging or both. Patients who were younger than 18 years and who developed ascites due to diseases other than malignancy were excluded from the study. A total of 150 patients were shortlisted using these criteria. Results: The mean age of the sample was 56.52 years with 101 (67%) of the patients being female, 54 (36%) diabetic, 55 (37%) hypertensive, 26 (52%) and 12 (8%) had ischemic heart disease. The most prevalent tumor reported was ovarian cancer 47 (31%) with the highest frequency of metastasis reported in the peritoneal region 34 (23%). Among symptoms, the most prevalent were abdominal distension 127 (85%), abdominal pain 99 (66%), 41 (27%) nausea, 44 (29%) vomiting and 32 (21%) reported weight change. Paracentesis was done in 139 (92%) for palliation of symptoms .Surgery was performed on 11 (7%) of the patients, whereas 70 (47%) of the patients were switched to chemotherapy with Carboplatin-Taxol constituting the major chemotherapeutic regimen. Majority 93 (62%) of the patients were discharged in a stable condition. The median survival following diagnosis of ascites was three months. Ovarian cancer favored longer survival while low serum albumin, low serum protein and liver metastases adversely affected survival. The independent prognostic factors for survival were cancer type, liver metastases and serum albumin. Conclusions: The identified independent prognostic factors should be used to select patients for multimodality therapy for adequate palliation.

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