scholarly journals Surgical resection of hepatic metastases from colorectal cancer: A systematic review of published studies

2006 ◽  
Vol 94 (7) ◽  
pp. 982-999 ◽  
Author(s):  
P C Simmonds ◽  
J N Primrose ◽  
J L Colquitt ◽  
O J Garden ◽  
G J Poston ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Surgical Resection ◽  
Hepatic Metastases

ATTACHE: A phase III, multicenter, randomized comparison of chemotherapy given prior to and post surgical resection versus chemotherapy given post surgical resection for hepatic metastases from colorectal cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. TPS3643-TPS3643
Author(s):  
Jonathan Fawcett ◽  
Katrin Marie Sjoquist ◽  
Rob Padbury ◽  
Christopher Christophi ◽  
Niall Christopher Tebbutt ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Adjuvant Chemotherapy ◽  
Liver Metastases ◽  
Surgical Resection ◽  
Operative Treatment ◽  
Primary Tumour ◽  
Hepatic Metastases ◽  
Phase Iii ◽  
Treatment Needs

TPS3643 Background: No randomized studies have directly compared the role of peri-operative to adjuvant chemotherapy for resectable liver metastases. Benefit from post operative compared to peri-operative treatment has been suggested in a recent retrospective study of 499 patients with resected colorectal liver metastases which showed improved survival with entirely post-operative chemotherapy. Given this data and that of the small randomised trials demonstrating improved surgical outcomes with adjuvant chemotherapy, the role of entirely post-operative chemotherapy as a means of improving outcomes while reducing the negative effects of pre-operative treatment needs to be examined. Methods: 200 patients randomized 1:1 to 6 months of treatment post-operatively or 3 months of treatment pre-operatively and 3 months post-operatively. Site investigators will nominate chemotherapy schedule (mFOLFOX6, XELOX or FOLFIRI when adjuvant oxaliplatin received previously) prior to randomisation. Primary endpoint: proportion of patients in each arm with surgical complications within 30 days. Secondary endpoints: proportion of patients completing planned chemotherapy, post operative mortality rate (in each group), tolerability and safety of treatment, response rate by RECIST V1.1 and CEA, time to progression, time to treatment failure, overall survival, QoL (EORTC QLQ-C30 and QLQ-LMC21). A planned prospective meta-analysis with MRC (UK) and NSABP C-11 trials will have sufficient power to examine the effect of schedule (peri- or post-operative) on progression free survival (PFS). Eligibility: Patients with histologically proven colorectal cancer with radiologically confirmed, resectable liver metastases without evidence of extra-hepatic disease are eligible. Patients with synchronous metastases who have undergone resection of the primary tumour are eligible but patients requiring combined resection of primary cancer and liver metastatic disease are excluded. Patients with involved hilar nodes or wound implant metastases will not be eligible. Trial Status: Study opened to accrual August 2011.

Surgical resection of hepatic metastases from neuroendocrine neoplasms: A systematic review

2012 ◽  
Vol 21 (3) ◽  
pp. e131-e141 ◽  
Author(s):  
Akshat Saxena ◽  
Terence C. Chua ◽  
Marlon Perera ◽  
Francis Chu ◽  
David L. Morris
Keyword(s):  
Systematic Review ◽  
Surgical Resection ◽  
Hepatic Metastases ◽  
Neuroendocrine Neoplasms

scholarly journals Intraoperative Ultrasound as a Screening Modality for the Detection of Liver Metastases during Resection of Primary Colorectal Cancer - A Systematic Review

2017 ◽  
Vol 03 (02) ◽  
pp. E60-E68 ◽  
Author(s):  
Signe Ellebæk ◽  
Claus Fristrup ◽  
Michael Mortensen
Keyword(s):  
Colorectal Cancer ◽  
Computed Tomography ◽  
Systematic Review ◽  
Liver Metastases ◽  
Detection Rate ◽  
Intraoperative Ultrasound ◽  
Hepatic Metastases ◽  
Laparoscopic Ultrasound ◽  
Preoperative Imaging ◽  
Synchronous Liver Metastases

AbstractColorectal cancer (CRC) is one of the most common cancer diseases worldwide. One in 4 patients with CRC will have a disseminated disease at the time of diagnosis and often in the form of synchronous liver metastases. Studies suggest that up to 30% of patients have non-recognized hepatic metastases during primary surgery for CRC. Intraoperative ultrasonography examination (IOUS) of the liver to detect liver metastases was considered the gold standard during open CRC surgery. Today laparoscopic surgery is the standard procedure, but laparoscopic ultrasound examination (LUS) is not performed routinely.Aim To perform a systematic review of the test performance of IOUS and LUS regarding the detection of synchronous liver metastases in patients undergoing surgery for primary CRC.Method The literature was systematically reviewed using the search engines: PubMed, Cochrane, Embase and Google. 21 studies were included in the review and the key words: intraoperative ultrasound, laparoscopic ultrasound, staging colon and rectum cancer.Results Intraoperative ultrasound showed a higher sensitivity, specificity, positive predictive value and overall accuracy for the detection liver metastases during surgery for primary CRC, compared to preoperative imaging modalities (ultrasound, computed tomography (CT) and contrast-enhanced computed tomography (CE-CT)). LUS showed a higher detection rate for liver metastases compared to CT, CE-CT and magnetic resonance imaging (MRI).Conclusion This systematic review found that both IOUS and LUS had a higher detection rate regarding liver metastases during primary CRC surgery, especially liver metastases<10 mm in diameter, when compared to US, CT, CE-CT and MRI.

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