scholarly journals A systematic review of a liver‐first approach in patients with colorectal cancer and synchronous colorectal liver metastases

HPB ◽  
2014 ◽  
Vol 16 (2) ◽  
pp. 101-108 ◽  
Author(s):  
Vincent W.T. Lam ◽  
Jerome M. Laurence ◽  
Tony Pang ◽  
Emma Johnston ◽  
Michael J. Hollands ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Synchronous Colorectal Liver Metastases

scholarly journals SIMULTANEOUS AND STAGED RESECTIONS FOR SYNCHRONOUS COLORECTAL LIVER METASTASES: META-ANALYSIS

2017 ◽  
pp. 6-21 ◽  
Author(s):  
A. A. Ponomarenko ◽  
Yu. A. Shelygin ◽  
E. G. Rybakov ◽  
S. I. Achkasov
Keyword(s):  
Colorectal Cancer ◽  
Liver Resection ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Meta Analysis ◽  
Survival Rates ◽  
Mortality Rates ◽  
Synchronous Colorectal Liver Metastases ◽  
Overall Survival Rates

AIM. To analyze the short-term and long-term outcomes two alternative surgical strategies: 1) simultaneous resections for colorectal cancer and synchronous colorectal liver metastases;2) conventional surgery for the primary tumor during the initial operation. After time, the liver resection is performed at a second operation METHODS. Meta-analysis was performed to compare outcomes simultaneous resections for colorectal cancer and synchronous colorectal liver metastases and staged surgery. Tumor localization, spread and number of metastasis, extent of operation, blood loss, length of hospital stay, postop mortality, complication rates, overall survival rates were analyzed. RESULTS. Twenty-nine studies with 5518 patients were included in meta-analysis. Multiple (р=0,007) and bilobed (р=0,0004) metastasis were more often in patients in group ofstaged resections. Major hepatectomy was also performed more often in group of staged resections. There were no significant differences in blood loss and postopirative mortality rates (p>0,05). Complication rate in group of simultaneous resections was lower than in group of staged resections (0R=0,8, 95 %CI: 0,7-1.0, p=0,048). 3- and 5-year overall survival rates were similar in both groups: 54% vs 55 %, and 37% vs 38%, respectively (р=0,007). CONCLUSION. Simultaneous resection of the primary tumor and the minor liver resection or extended hepatectomy in selected patients didn’t adversely affect on complications and mortality rates in equivalent long-term survival compared to staged liver resection. An important limitation of the present study is the bias and heterogeneity in compared groups due to retrospective data over the 20-year period.

scholarly journals Simultaneous, Delayed and Liver-First Hepatic Resections for Synchronous Colorectal Liver Metastases: A Systematic Review and Network Meta-Analysis

2019 ◽  
Vol 11 (8) ◽  
pp. 572-582 ◽  
Author(s):  
Paschalis Gavriilidis ◽  
Konstantinos Katsanos ◽  
Robert P. Sutcliffe ◽  
Constantinos Simopoulos ◽  
Daniel Azoulay ◽  
...  
Keyword(s):  
Systematic Review ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Meta Analysis ◽  
Synchronous Colorectal Liver Metastases

scholarly journals Contemporary surgical management of synchronous colorectal liver metastases

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 598 ◽  
Author(s):  
Danielle Collins ◽  
Heidi Chua
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Surgical Resection ◽  
Colorectal Liver Metastases ◽  
Survival Rates ◽  
Timing Of Surgery ◽  
Optimal Management ◽  
Multimodal Approach ◽  
Stage 4 ◽  
Synchronous Colorectal Liver Metastases

Historically, the 5-year survival rates for patients with stage 4 (metastatic) colorectal cancer were extremely poor (5%); however, with advances in systemic chemotherapy combined with an ability to push the boundaries of surgical resection, survival rates in the range of 25–40% can be achieved. This multimodal approach of combining neo-adjuvant strategies with surgical resection has raised a number of questions regarding the optimal management and timing of surgery. For the purpose of this review, we will focus on the treatment of stage 4 colorectal cancer with synchronous liver metastases.

scholarly journals Simultaneous versus delayed hepatectomy for synchronous colorectal liver metastases: a systematic review and meta-analysis

HPB ◽  
2018 ◽  
Vol 20 (1) ◽  
pp. 11-19 ◽  
Author(s):  
Paschalis Gavriilidis ◽  
Robert P. Sutcliffe ◽  
James Hodson ◽  
Ravi Marudanayagam ◽  
John Isaac ◽  
...  
Keyword(s):  
Systematic Review ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Meta Analysis ◽  
Synchronous Colorectal Liver Metastases

scholarly journals Open Resection Compared to Mini-Invasive in Colorectal Cancer and Liver Metastases: A Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Jie Gong ◽  
Fengwei Gao ◽  
Qingyun Xie ◽  
Xin Zhao ◽  
Zehua Lei
Keyword(s):  
Colorectal Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Liver Metastases ◽  
Invasive Surgery ◽  
Open Surgery ◽  
Colorectal Liver Metastases ◽  
Disease Free Survival ◽  
Simultaneous Resection ◽  
Synchronous Colorectal Liver Metastases

Background: We performed a meta-analysis to evaluate the outcomes of minimally invasive surgery and open surgery in the simultaneous resection of colorectal cancer and synchronous colorectal liver metastases.Methods: A systematic literature search up to April 2021 was done and 13 studies included 1,181 subjects with colorectal cancer and synchronous colorectal liver metastases at the start of the study; 425 of them were using minimally invasive surgery and 756 were open surgery. They were reporting relationships between the outcomes of minimally invasive surgery and open surgery in the simultaneous resection of colorectal cancer and synchronous colorectal liver metastases. We calculated the odds ratio (OR) or the mean difference (MD) with 95% CIs to assess the outcomes of minimally invasive surgery and open surgery in the simultaneous resection of colorectal cancer and synchronous colorectal liver metastases using the dichotomous or continuous method with a random or fixed-effect model.Results: Minimally invasive surgery in subjects with colorectal cancer and synchronous colorectal liver metastases was significantly related to longer operation time (MD, 35.61; 95% CI, 7.36–63.87, p = 0.01), less blood loss (MD, −151.62; 95% CI, −228.84 to −74.40, p < 0.001), less blood transfusion needs (OR, 0.61; 95% CI, 0.42–0.89, p = 0.01), shorter length of hospital stay (MD, −3.26; 95% CI, −3.67 to −2.86, p < 0.001), lower overall complications (OR, 0.59; 95% CI, 0.45–0.79, p < 0.001), higher overall survival (OR, 1.66; 95% CI, 1.21–2.29, p = 0.002), and higher disease-free survival (OR, 1.49; 95% CI, 1.13–1.97, p = 0.005) compared to open surgery.Conclusions: Minimally invasive surgery in subjects with colorectal cancer and synchronous colorectal liver metastases may have less blood loss, less blood transfusion needs, shorter length of hospital stay, lower overall complications, higher overall survival, and higher disease-free survival with longer operation time compared with the open surgery. Furthers studies are required to validate these findings.

scholarly journals The liver-first approach for synchronous colorectal liver metastases: A systematic review and meta-analysis of completion rates and effects on survival

2021 ◽  
pp. 145749692110301
Author(s):  
Adam Zeyara ◽  
William Torén ◽  
Kjetil Søreide ◽  
Roland Andersson
Keyword(s):  
Systematic Review ◽  
Overall Survival ◽  
Liver Metastases ◽  
Survival Benefit ◽  
Colorectal Liver Metastases ◽  
Meta Analysis ◽  
Completion Rate ◽  
Completion Rates ◽  
Synchronous Colorectal Liver Metastases ◽  
Oncologic Therapy

Background: Patients presenting with synchronous colorectal liver metastases are increasingly being considered for a curative treatment, and the liver-first approach is gaining popularity in this context. However, little is known about the completion rates of the liver-first approach and its effects on survival. Methods: A systematic review and meta-analysis of liver-first strategy for colorectal liver metastasis. The primary outcome was an assessment of the completion rates of the liver-first approach. Secondary outcomes included overall survival, causes of non-completion, and clinicopathologic data. Results: Seventeen articles were amenable for inclusion and the total study population was 1041. The median completion rate for the total population was 80% (range 20–100). The median overall survival for the completion and non-completion groups was 45 (range 12–69) months and 13 (range 10.5–25) months, respectively. Metadata showed a significant survival benefit for the completion group, with a univariate hazard ratio of 12.0 (95% confidence interval, range 5.7–24.4). The major cause of non-completion (76%) was liver disease progression before resection of the primary tumor. Pearson tests showed significant negative correlation between median number of lesions and median size of the largest metastasis and completion rate. Conclusions: The liver-first approach offers a complete resection to most patients enrolled, with an overall survival benefit when completion can be assured. One-fifth fails to return to intended oncologic therapy and the major cause is interim metastatic progression, most often in the liver. Risk of non-completion is related to a higher number of lesions and large metastases. The majority of studies stem from primary rectal cancers, which may influence on the return to intended oncologic therapy as well. PROSPERO id no: 170459

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