Prognostic Value of Postoperative Carcinoembryonic Antigen Concentration and Extent of Invasion of Resection Margins after Hepatic Resection for Colorectal Metastases

2000 ◽  
Vol 166 (7) ◽  
pp. 557-561 ◽  
Author(s):  
Pascal Gervaz, Alec Blanchard, Sandro Pamp
Keyword(s):  
Hepatic Resection ◽  
Carcinoembryonic Antigen ◽  
Prognostic Value ◽  
Colorectal Metastases ◽  
Resection Margins ◽  
Antigen Concentration

Phase II Trial of Carcinoembryonic Antigen Radioimmunotherapy With 131I-Labetuzumab After Salvage Resection of Colorectal Metastases in the Liver: Five-Year Safety and Efficacy Results

2005 ◽  
Vol 23 (27) ◽  
pp. 6763-6770 ◽  
Author(s):  
Torsten Liersch ◽  
Johannes Meller ◽  
Bettina Kulle ◽  
Thomas M. Behr ◽  
Peter Markus ◽  
...  
Keyword(s):  
Carcinoembryonic Antigen ◽  
Phase Ii ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Colorectal Metastases ◽  
Resection Margins ◽  
Safety And Efficacy ◽  
Curative Therapy ◽  
Salvage Resection ◽  
Grade 3

Purpose Although complete resection (R0) of liver metastases (LM) remains the treatment of choice for colorectal cancer (CRC) patients amenable to curative therapy, only approximately one third survive for 5 years. The objective of this phase II study was to evaluate the safety and efficacy of radioimmunotherapy (RAIT) after salvage resection of LM. Patients and Methods Twenty-three patients who underwent surgery for LM of CRC received a dose of 40 to 60 mCi/m2 of 131I-labetuzumab, which is a humanized monoclonal antibody against carcinoembryonic antigen. Safety (n = 23), disease-free survival (DFS; n = 19), and overall survival (OS; n = 19) were determined. Results With a median follow-up of 64 months, the median OS time from the first liver resection for RAIT patients was 68.0 months (95% CI, 46.0 months to infinity), and the median DFS time was 18.0 months (95% CI, 11.0 to 31.0 months). The 5-year survival rate was 51.3%. RAIT benefited patients independently of bilobar involvement, size and number of LM, and resection margins. The major adverse effect was transient myelosuppression, resulting mostly in grade ≤ 3 neutropenia and/or thrombocytopenia. Conclusion Because both the median OS and 5-year survival rates seem to be improved with adjuvant RAIT after complete LM resection in CRC, compared with historical and contemporaneous controls not receiving RAIT, these results justify further evaluation of this modality in a multicenter, randomized trial.

scholarly journals Resection Margins for Colorectal Metastases to The Liver: Do They Make A Difference?

HPB Surgery ◽  
1996 ◽  
Vol 9 (2) ◽  
pp. 115-117 ◽  
Author(s):  
Reid B. Adams ◽  
Bernard Langer
Keyword(s):  
Hepatic Resection ◽  
Liver Tumors ◽  
Hepatic Metastases ◽  
Metastatic Tumor ◽  
Intrahepatic Metastasis ◽  
Colorectal Metastases ◽  
Resection Margins ◽  
Colorectal Cancers ◽  
Usual Procedure ◽  
Metastatic Lesions

Objective: The authors determined an appropriate surgical treatment for liver metastases from colorectal cancers. Clinicopathologic featuresof metastatic lesions of colorectal cancers were studied.Summary Background Data: Major hepatic resection is the usual procedure for treatment of hepatic metastases from colorectal cancers.Methods: Forty consecutive patients who underwent hepatic resections were prospectively studied, for a total of 89 metastatic liver tumors.Results: Metastatic tumor often extended along Glisson’s capsule, including invasion to the portal vein (9 cases), the hepatic vein (3 cases), the bile duct (16 cases), and the nerve (6 cases). The main tumor had small satellite nodules in only one patient, and there were no microscopic deposits in the parenchyma, even within 10 mm from the metastatic tumors. Fibrous pseudocapsule formation was observed in 28 patients.Discussion: The rarity of intrahepatic metastasis from metastatic tumor supports nonanatomic limited hepatic resection as the procedure of choice for metastatic colorectal cancer in the liver. The spread via Glisson's capsule should be taken into consideration for complete tumor clearance.

scholarly journals Circulating tumor cell-related transcripts in blood as prognostic biomarkers of early recurrence after liver resection for colorectal metastases

2019 ◽  
Vol 34 (3) ◽  
pp. 269-275
Author(s):  
Felice Giuliante ◽  
Elena Panettieri ◽  
Francesco Ardito ◽  
Agostino De Rose ◽  
Krizia Pocino ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Resection ◽  
Tumor Cell ◽  
Carcinoembryonic Antigen ◽  
Growth Factor Receptor ◽  
Predictive Biomarker ◽  
Circulating Tumor Cell ◽  
Early Recurrence ◽  
Colorectal Metastases

Background: Several prognostic factors were proposed to improve early detection of recurrence after liver resection of metastases of colorectal cancer. Circulating tumor cell-related transcripts were evaluated in colorectal cancer patients with conflicting results. The aim of this study was to investigate usefulness of carcinoembryonic antigen CAM5, epidermal growth factor receptor, and ERCC1 transcripts in the bloodstream as predictive factors of recurrence in patients who underwent liver resection for metastases of colorectal cancer. Methods: Peripheral blood was collected from 29 patients at the time of the colorectal cancer liver metastasis resection, and from 25 normal controls. Follow-up draws (FUDs) were also performed at 30 days, and 3 and 12 months since surgery. On each sample, carcinoembryonic antigen CAM5, ERCC1, and GAPDH mRNAs were examined by quantitative reverse transcription (qRT). Results: Carcinoembryonic antigen transcript levels were linearly correlated to the number of spiked cells (qRT analytical limit = five cells). Among 29 patients (20 M/9 F; mean age 63 years (range 32–79), highly significant levels of carcinoembryonic antigen, if compared to the baseline, were detected in those relapsing after surgery ( P <0.05). The main differences were between the 1st- and 12th-month FUDs. Significantly higher levels of carcinoembryonic antigen were also detected in patients who died from disease progression during the follow-up (as evaluated at 30 days and 90 days FUDs). Conclusions: Blood carcinoembryonic antigen-mRNA absolute copy number overtime variation can represent a valid early predictor of relapse after liver resection in colorectal liver metastases patients. Prospective studies, in the context of large clinical trials, will provide further data to also qualify ERCC1 as a predictive biomarker for decisions on therapeutic strategies.

scholarly journals Hepatic Cryotherapy for Cancer: A Reviewand Critique

HPB Surgery ◽  
1996 ◽  
Vol 9 (2) ◽  
pp. 118-120 ◽  
Author(s):  
D. L. Morris
Keyword(s):  
Postoperative Complications ◽  
Hepatic Resection ◽  
Study Design ◽  
Hepatic Failure ◽  
Resection Margin ◽  
Early Experience ◽  
Resection Margins ◽  
Tumor Clearance

Background: Wedge or other nonanatomic hepatic resections, performed in an attempt to spare functional parenchyma, often are not accomplished with clear resection margins and may be complicated by hemorrhage from the depth of the resection.Study Design: The current study describes a technique of cryoassisted hepatic resection that allows for controlled resection with well-defined margins. The early experience in managing 16 tumors in 13 patients is reported.Results: A cryoprobe is inserted into the tumor and freezing performed to a predetermined resection margin using ultrasound control. The ice ball, so formed, is then maintained and excised. The management of these 13 patients was associated with one intraoperative and two postoperative complications, including a death of a patient with cirrhosis who had infected ascites and died as a result of hepatic failure.Conclusions: Cryoassisted hepatic resection seems to be safe and allows resection with good tumor clearance and maximal preservation of functional parenchyma.

scholarly journals Prognostic value of pathologic characteristics and resection margins in tracheal adenoid cystic carcinoma

2010 ◽  
Vol 37 (6) ◽  
pp. 1438-1444 ◽  
Author(s):  
Jimmie Honings ◽  
Henning A. Gaissert ◽  
Alissa C. Weinberg ◽  
Eugene J. Mark ◽  
Cameron D. Wright ◽  
...  
Keyword(s):  
Adenoid Cystic Carcinoma ◽  
Prognostic Value ◽  
Resection Margins ◽  
Adenoid Cystic

Chemotherapy Regimen Predicts Steatohepatitis and an Increase in 90-Day Mortality After Surgery for Hepatic Colorectal Metastases

2006 ◽  
Vol 24 (13) ◽  
pp. 2065-2072 ◽  
Author(s):  
Jean-Nicolas Vauthey ◽  
Timothy M. Pawlik ◽  
Dario Ribero ◽  
Tsung-Teh Wu ◽  
Daria Zorzi ◽  
...  
Keyword(s):  
Liver Injury ◽  
Hepatic Resection ◽  
Odds Ratio ◽  
Hepatic Injury ◽  
Chemotherapy Regimen ◽  
Postoperative Outcome ◽  
Colorectal Metastases ◽  
Hepatic Surgery ◽  
Perioperative Outcome ◽  
Pathologic Analysis

Purpose Chemotherapy before resection of hepatic colorectal metastases (CRM) may cause hepatic injury and affect postoperative outcome. Patients and Methods Four hundred six patients underwent hepatic resection of CRM between 1992 and 2005. Pathologic review of the nontumorous liver was performed using established criteria for steatosis, steatohepatitis, and sinusoidal injury. The effect of chemotherapy and liver injury on perioperative outcome was analyzed. Results One hundred fifty-eight patients (38.9%) received no preoperative chemotherapy, whereas 248 patients (61.1%) did. The median duration of chemotherapy was 16 weeks (range, 2 to 70 weeks). Chemotherapy consisted of fluoropyrimidine-based regimens (fluorouracil [FU] alone, 15.5%; irinotecan plus FU, 23.1%; and oxaliplatin plus FU, 19.5%) and other therapy (3.0%). On pathologic analysis, 36 patients (8.9%) had steatosis, 34 (8.4%) had steatohepatitis, and 22 (5.4%) had sinusoidal dilation. Oxaliplatin was associated with sinusoidal dilation compared with no chemotherapy (18.9% v 1.9%, respectively; P < .001; odds ratio [OR] = 8.3; 95% CI, 2.9 to 23.6). In contrast, irinotecan was associated with steatohepatitis compared with no chemotherapy (20.2% v 4.4%, respectively; P < .001; OR = 5.4; 95% CI, 2.2 to 13.5). Patients with steatohepatitis had an increased 90-day mortality compared with patients who did not have steatohepatitis (14.7% v 1.6%, respectively; P = .001; OR = 10.5; 95% CI, 2.0 to 36.4). Conclusion Steatohepatitis is associated with an increased 90-day mortality after hepatic surgery. In patients with hepatic CRM, the chemotherapy regimen should be carefully considered because the risk of hepatotoxicity is significant.

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