Curative-intent treatment of recurrent colorectal liver metastases: A comparison between ablation and resection

2017 ◽  
Vol 43 (10) ◽  
pp. 1901-1907 ◽  
Author(s):  
Aurélien Dupré ◽  
Robert P. Jones ◽  
Rafael Diaz-Nieto ◽  
Stephen W. Fenwick ◽  
Graeme J. Poston ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Curative Intent

scholarly journals FIRST BRAZILIAN CONSENSUS ON MULTIMODAL TREATMENT OF COLORECTAL LIVER METASTASES. MODULE 1: PRE-TREATMENT EVALUATION

2015 ◽  
Vol 28 (4) ◽  
pp. 222-230 ◽  
Author(s):  
Felipe José Fernandez COIMBRA ◽  
Heber Salvador de Castro RIBEIRO ◽  
Márcio Carmona MARQUES ◽  
Paulo HERMAN ◽  
Rubens CHOJNIAK ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Multimodal Treatment ◽  
Colorectal Liver Metastases ◽  
Epidemiological Data ◽  
Treatment Modalities ◽  
Established Method ◽  
Curative Intent ◽  
Pre Treatment ◽  
Definition Of

Background : Liver metastases of colorectal cancer are frequent and potentially fatal event in the evolution of patients with these tumors. Aim : In this module, was contextualized the clinical situations and parameterized epidemiological data and results of the various treatment modalities established. Method: Was realized deep discussion on detecting and staging metastatic colorectal cancer, as well as employment of imaging methods in the evaluation of response to instituted systemic therapy. Results : The next step was based on the definition of which patients would have their metastases considered resectable and how to expand the amount of patients elegible for modalities with curative intent. Conclusion : Were presented clinical, pathological and molecular prognostic factors, validated to be taken into account in clinical practice.

scholarly journals The Prognostic Value of Preoperative Serum Lactate Dehydrogenase (LDH) Levels in Patients Underwent Curative-intent Hepatectomy For Colorectal Liver Metastases: A Two-Center Cohort Study

2021 ◽  
Author(s):  
Long Bai ◽  
Ze-Yu Lin ◽  
Yun-Xin Lu ◽  
Qin Chen ◽  
Han Zhou ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lactate Dehydrogenase ◽  
Liver Metastases ◽  
Peer Review ◽  
Cancer Patients ◽  
Prognostic Value ◽  
Colorectal Liver Metastases ◽  
Curative Intent ◽  
Preoperative Serum ◽  
Colorectal Cancer Patients

Abstract Background. The prognostic value of lactate dehydrogenase (LDH) in colorectal cancer patients has remained inconsistent between non-metastatic and metastatic settings. So far, very few studies have included LDH in the prognostic analysis of curative-intent surgery for colorectal liver metastases (CRLM).Patients and Methods. 580 consecutive metastatic colorectal cancer patients who underwent curative-intent CRLM resection from Blinded for peer review (434 patients) and Blinded for peer review (146 patients) treated in 2000-2019 were enrolled. Overall survival (OS) was the primary endpoint. Cox regression model was performed to identify the prognostic values of preoperative serum LDH levels and other clinicopathology variables. A modification of the established Fong CRS scoring system comprising LDH was developed within this Chinese population.Results. At the median follow-up time of 60.5 months, and median OS was 59.5 months in the pooled cohort. In the multivariate analysis, preoperative LDH > upper limit of normal (250 U/L) was the strongest independent prognostic factor for OS (HR 1.73, 95% confidence interval [CI], 1.22-2.44; P < .001). Patients with elevated LDH levels showed impaired OS than patients with normal LDH levels (27.6 months vs. 68.8 months). Five-year survival rates were 53.7% and 22.5% in the LDH-normal group and LDH-high group, respectively. Similar results were also confirmed in each cohort. In the subgroup analysis, LDH could distinguish the survival regardless of most established prognostic factors (number and size of CRLM, surgical margin, extrahepatic metastases, CEA and CA19-9 levels, etc.). Integrating LDH into the Fong score contributed to an improvement in the predictive value. Conclusion. Our study implicates serum LDH as a reliable and independent laboratory biomarker to predict the clinical outcome of curative-intent surgery for CRLM. Composite of LDH and Fong score is a potential stratification tool for CRLM resection. Prospective, international studies are needed to validate these results across diverse populations.

Curative-Intent Treatment for Colorectal Liver Metastases: A Medical Oncologist's Perspective

2012 ◽  
pp. 205-208 ◽  
Author(s):  
Leonard B. Saltz
Keyword(s):  
Liver Metastases ◽  
Patient Selection ◽  
Colorectal Liver Metastases ◽  
Curative Intent ◽  
Treatment Choices ◽  
Unresectable Disease ◽  
Realistic Assessment

Overview: Resection or ablation of CRC liver metastases can be offered with curative intent in some, but not all patients in whom resection is technically possible. Chemotherapy can improve the potential for cure to some degree, either in the adjuvant or neoadjuvant setting, or, in relatively rare circumstances, by converting truly unresectable disease into resectable. Careful and realistic patient selection, with an individualized and realistic assessment of curative potential, is key to providing each patient with the means to make realistic treatment choices.

Actual 10-Year Survival After Resection of Colorectal Liver Metastases Defines Cure

2007 ◽  
Vol 25 (29) ◽  
pp. 4575-4580 ◽  
Author(s):  
James S. Tomlinson ◽  
William R. Jarnagin ◽  
Ronald P. DeMatteo ◽  
Yuman Fong ◽  
Peter Kornprat ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Randomized Clinical Trials ◽  
Curative Intent ◽  
Term Survival ◽  
Number Of Patients ◽  
Disease Free ◽  
Disease Specific

Purpose Resection of colorectal liver metastases (CLM) in selected patients has evolved as the standard of care during the last 20 years. In the absence of prospective randomized clinical trials, a survival benefit has been deduced relative to historical controls based on actuarial data. There is now sufficient follow-up on a significant number of patients to address the curative intent of resecting CLM. Methods Retrospective review of a prospectively maintained database was performed on patients who underwent resection of CLM from 1985 to 1994. Postoperative deaths were excluded. Disease-specific survival (DSS) was calculated from the time of hepatectomy using the Kaplan-Meier method. Results There were 612 consecutive patients identified with 10-year follow-up. Median DSS was 44 months. There were 102 actual 10-year survivors. Ninety-nine (97%) of the 102 were disease free at last follow-up. Only one patient experienced a disease-specific death after 10 years of survival. In contrast, 34% of the 5-year survivors suffered a cancer-related death. Previously identified poor prognostic factors found among the 102 actual 10-year survivors included 7% synchronous disease, 36% disease-free interval less than 12 months, 25% bilobar metastases, 50% node-positive primary, 39% more than one metastasis, and 35% tumor size more than 5 cm. Conclusion Patients who survive 10 years appear to be cured of their disease, whereas approximately one third of actual 5-year survivors succumb to a cancer-related death. In well-selected patients, there is at least a one in six chance of cure after hepatectomy for CLM. The presence of poor prognostic factors does not preclude the possibility of long-term survival and cure.

How to reduce the risk of recurrence after surgical treatment of colorectal liver metastases?

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 544-544
Author(s):  
L. Benhaim ◽  
D. Goárá ◽  
S. Bonnet ◽  
F. Dumont ◽  
D. Malka ◽  
...  
Keyword(s):  
High Risk ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Systemic Chemotherapy ◽  
Recurrence Free Survival ◽  
Curative Intent ◽  
Technical Problems ◽  
Free Survival ◽  
Hepatic Recurrence ◽  
Liver Recurrence

544 Background: After surgery with curative intent for colorectal liver metastases (MHCCR), liver recurrence occurs in more than 60% of patients, despite the administration of adjuvant systemic chemotherapy. The objective of this study was to compare the prognosis of patients operated on MHCCR with high risk of recurrences in the liver, treated by postoperative chemotherapy hepatic arterial infusion (HAI) by oxaliplatin, to that obtained after adjuvant systemic chemotherapy. Methods: From January 2000 to December 2009, 113 patients who underwent curative resection of more than 3 MHCCR, were selected from a prospective database. Among these 113 patients, 47 had received postoperative HAI associated with systemic chemotherapy (HAI+) and 66, systemic chemotherapy alone (HAI-). Results: The two groups were comparable in age, sex, stage of primary, rates of synchronous (> 75%), and bilobar (> 90%) MHCCR. The number of MHCCR was significantly higher in the group HAI+ (p < 0.0001). Twenty-seven patients (57%) received more than 6 courses of HAI. HAI was discontinued in 6 patients (12%) due to technical problems with the catheter. After a median follow up of 75 months (7-125), the overall survival and recurrence-free survival at 5 years were higher for patients HAI+ compared to those HAI-, respectively 52.9% vs. 12.3% (p = 0.06) and 30.8% vs. 2% (p < 0.0001). Conclusions: The postoperative administration of oxaliplatin-based HAI associated to systemic chemotherapy after cure of MHCCR, improves recurrence-free survival of patients at high risk of hepatic recurrence, compared to systemic chemotherapy alone. No significant financial relationships to disclose.

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