Resection of Liver Metastases: A Treatment Provides a Long-Term Survival Benefit for Patients with Advanced Pancreatic Neuroendocrine Tumors: A Systematic Review and Meta-Analysis

Purpose. Nonsurgical therapies, including biotherapy, chemotherapy, and liver-directed therapy, provided a limit survival benefit for PNET patients with hepatic metastases. With the development of liver resection technique, there was a controversy on whether to perform a liver resection for these patients. Methods. A computerized search was made of the Medline/PubMed, EMbase, Cochrane Library, and SinoMed (CBM) before March 2018. A meta-analysis was performed to investigate the differences in the efficacy of liver resection and nonliver resection treatments based on the evaluation of morbidity, 30-day mortality, symptom relief rate, and 1-, 3-, and 5-year survival. Two investigators reviewed all included articles and extracted the data of them. The meta-analysis was performed via Review Manager 5.3 software. Results. A total of 13 cohort studies with 1524 patients were included in this meta-analysis. Compared with the nonliver resection group, liver resection group had a longer 1-, 3-, and 5-year survival time and a higher symptom relief with an acceptable mortality and morbidity. Conclusions. Liver resection is a safe treatment and could significantly prolong the long-term prognosis for highly selected patients with resectable liver metastases from PNET. Further randomized, controlled trials are needed.

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Long-Term Survival of Two Patients with Liver Metastases from Advanced Gastric Cancer Treated with Radiofrequency Ablation and Chemotherapy

Case Reports in Oncology ◽

10.1159/000507849 ◽

2021 ◽

pp. 67-72

Author(s):

Sung Jin Oh

Keyword(s):

Gastric Cancer ◽

Radiofrequency Ablation ◽

Liver Metastases ◽

Advanced Gastric Cancer ◽

Systemic Chemotherapy ◽

Subtotal Gastrectomy ◽

Hepatic Metastases ◽

Term Survival ◽

Long Term Survival

Liver metastasis from gastric cancer has a very poor prognosis. Herein, we present two cases of liver metastases (synchronous and metachronous) from advanced gastric cancer. In the first case, the patient underwent radical subtotal gastrectomy. Liver metastases occurred 6 months after surgery while the patient was receiving adjuvant chemotherapy, but two hepatic tumors were successfully removed by radiofrequency ablation (RFA). In the second case, liver metastases occurred 15 months after surgery for gastric cancer. The patient also received RFA for one hepatic tumor, and other suspicious metastatic tumors were treated with systemic chemotherapy. Although these case presentations are limited for the efficacy of RFA treatment with systemic chemotherapy for hepatic metastases from gastric cancer, our findings showed long-term survival (overall survival for 108 and 67 months, respectively) of the affected patients, without recurrence. Therefore, we suggest that RFA treatment with systemic chemotherapy could be an effective alternative treatment modality for hepatic metastases from gastric cancer.

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

Journal of Clinical Medicine ◽

10.3390/jcm10051141 ◽

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.

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P-166 Re-hepatectomy is a predictor of long-term survival in patients that recur after liver resection of colorectal liver metastases

Annals of Oncology ◽

10.1093/annonc/mdw199.160 ◽

2016 ◽

Vol 27 ◽

pp. ii49

Author(s):

M. Marques ◽

H.S. de Castro Ribeiro ◽

W.L. Costa ◽

A.L. Diniz ◽

A. Godoy ◽

...

Keyword(s):

Liver Resection ◽

Liver Metastases ◽

Colorectal Liver Metastases ◽

Term Survival ◽

Long Term Survival

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Nonresponse to pre-operative chemotherapy does not preclude long-term survival after liver resection in patients with colorectal liver metastases

Surgery ◽

10.1016/j.surg.2009.02.004 ◽

2009 ◽

Vol 146 (1) ◽

pp. 52-59 ◽

Cited By ~ 31

Author(s):

Ulf P. Neumann ◽

Armin Thelen ◽

Christoph Röcken ◽

Daniel Seehofer ◽

Marcus Bahra ◽

...

Keyword(s):

Liver Resection ◽

Liver Metastases ◽

Colorectal Liver Metastases ◽

Term Survival ◽

Long Term Survival

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

Koloproktologia ◽

10.33878/2073-7556-2017-0-3-6-21 ◽

2017 ◽

pp. 6-21 ◽

Cited By ~ 3

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.

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Efficacy of Neoadjuvant Therapy in Improving Long-Term Survival of Patients With Resectable Rectal Cancer: A Meta-Analysis

10.21203/rs.3.rs-146988/v1 ◽

2021 ◽

Author(s):

Xinlong Li ◽

Xiangyuan Li ◽

Rongrong Fu ◽

Derry Minyao Ng ◽

Tong Yang ◽

...

Keyword(s):

Rectal Cancer ◽

Neoadjuvant Therapy ◽

Meta Analysis ◽

Low Rectal Cancer ◽

Cochrane Library ◽

Term Survival ◽

Resectable Rectal Cancer ◽

Long Term Prognosis ◽

The Impact

Abstract Background: The impact of neoadjuvant therapy on the long-term prognosis of patients with resectable rectal cancer is controversial. This study aimed to explore the effect of neoadjuvant therapy on the long-term prognosis of patients with resectable rectal cancer. Methods: Four major databases (PubMed, Web of Science, Embase, Cochrane library) were searched to find relevant articles published between January 2000 and July 2020. The main outcome indicators were the 5-year overall survival (OS) and disease-free survival (DFS). Results: Compared with upfront surgery, our meta-analysis showed that 5-year OS (HR: 0.84, 95% Cl: 0.78-0.91) and DFS (HR: 0.91, 95% Cl: 0.87-0.95) were prolonged for patients with resectable rectal cancer after receiving neoadjuvant therapy. The results of subgroup analysis suggested that both neoadjuvant short-course radiotherapy (SCRT) and neoadjuvant chemo-radiotherapy (CRT) could improve the 5-year OS and DFS. The 5-year OS and DFS of patients with stage Ⅱ-Ⅲ rectal cancer increased significantly and the improvement of 5-year OS and DFS could also be observed in mid/low rectal cancer.Conclusion: Neoadjuvant therapy could improve the long-term survival of patients with mid/low rectal cancer in stage Ⅱ-Ⅲ. For the treatment, neoadjuvant SCRT and neoadjuvant CRT were recommended.

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The Role of Vitamin D on the Prognosis and Incidence of Lung Cancer: A Systematic Review and Meta-Analysis

10.21203/rs.3.rs-201134/v1 ◽

2021 ◽

Author(s):

Mingxia Qian ◽

Dina Guo ◽

Rongrong Fu ◽

Shuping Qi ◽

Xiaojun Fu ◽

...

Keyword(s):

Lung Cancer ◽

Vitamin D ◽

Cancer Patients ◽

Meta Analysis ◽

Cochrane Library ◽

Term Survival ◽

Long Term Survival ◽

Lung Cancer Patients ◽

Vitamin D Intake

Abstract Background: The correlation between vitamin D intake and lung cancer development is controversial. This meta-analysis aims to evaluate the relationship between vitamin D and the prognosis and incidence of lung cancer. Methods: A comprehensive database search on Pubmed, Web of Science, EBSCO, and Cochrane Library was carried out from the beginning to November 2020. Long-term survival and the incidence rate of patients with lung cancer were the primary outcomes of the study. Results: Ten eligible studies were selected for the meta-analysis following specific inclusion and exclusion criteria. Four included studies, covering 5007 patients, compared the overall survival (OS) and relapse-free survival (RFS) of lung cancer patients among total vitamin D users with non-users. Significantly, the estimated pooled hazard ratio (HR) revealed that vitamin D could improve OS and RFS of lung cancer patients [HR=0.83, 95% CI (0.72-0.95); HR=0.79, 95% CI (0.61-0.97), respectively]. Vitamin D intake was inversely associated with lung cancer incidence in six studies [OR=0.90, 95% CI (0.83-0.97)]. Conclusions: The present meta-analysis shows vitamin D not only improves the long-term survival of lung cancer patients but has a beneficial effect on the incidence of lung cancer. Notwithstanding, more studies are needed to confirm the study results.

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Efficacy of Neoadjuvant Therapy in Improving Long-Term Survival of Patients with Resectable Rectal Cancer: A Meta-Analysis

Anti-Cancer Agents in Medicinal Chemistry ◽

10.2174/1871520621666210726134809 ◽

2021 ◽

Vol 21 ◽

Author(s):

Xinlong Li ◽

Xiangyuan Li ◽

Rongrong Fu ◽

Derry Ng ◽

Tong Yang ◽

...

Keyword(s):

Rectal Cancer ◽

Neoadjuvant Therapy ◽

Meta Analysis ◽

Low Rectal Cancer ◽

Cochrane Library ◽

Term Survival ◽

Long Term Survival ◽

Resectable Rectal Cancer ◽

Long Term Prognosis

Background: The impact of neoadjuvant therapy on long-term prognosis of patients with resectable rectal cancer is currently unknown. Objective: This study aimed to explore the long-term prognosis of patients with resectable rectal cancer following treatment with neoadjuvant therapy. Methods: Four major databases (PubMed, Web of Science, Embase, Cochrane library) were searched to identify relevant articles published between January 2000 and July 2020. The main outcome indicators were the 5-year overall survival (OS) and disease-free survival (DFS). Results: The meta-analysis revealed that 5-year OS (HR: 0.88, 95% Cl: 0.83-0.93) and DFS (HR: 0.95, 95% Cl: 0.91-0.98) were higher in patients with resectable rectal cancer after receiving neoadjuvant therapy than those treated with upfront surgery. Subgroup analysis demonstrated that the long-term survival of patients in Asia and Europe could benefit from neoadjuvant therapy. The neoadjuvant short-course radiotherapy (SCRT) and neoadjuvant chemo-radiotherapy (CRT) improved the 5-year OS and DFS of patients with stage Ⅱ-Ⅲ rectal cancer and mid/low rectal cancer. Further research found that patients with stage Ⅱ only had an increase in OS, while patients with stage Ⅲ have improved 5-year OS and DFS. Conclusion: Neoadjuvant therapy improved the long-term survival of patients with mid/low rectal cancer in stage Ⅱ-Ⅲ (especially stage Ⅲ). Additionally, patients in Asia and Europe seemed to be more likely to benefit from neoadjuvant therapy. For the treatment, we recommend neoadjuvant SCRT and neoadjuvant CRT for resectable rectal cancer.

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Systematic Review and Meta-Analysis of Liver Resection for Colorectal Metastases in Elderly Patients

Digestive Surgery ◽

10.1159/000487274 ◽

2018 ◽

Vol 36 (2) ◽

pp. 111-123 ◽

Cited By ~ 8

Author(s):

Tim van Tuil ◽

Ali A. Dhaif ◽

Wouter W. te Riele ◽

Bert van Ramshorst ◽

Hjalmar C. van Santvoort

Keyword(s):

Systematic Review ◽

Liver Resection ◽

Elderly Patients ◽

Postoperative Morbidity ◽

Meta Analysis ◽

Colorectal Metastases ◽

Cochrane Library ◽

Long Term Outcomes ◽

Short And Long Term

Background: This systematic review and meta-analysis evaluated the short- and long-term outcomes of liver resection for colorectal liver metastases (CRLM) in elderly patients. Methods: A PubMed, EMBASE, and Cochrane Library search was performed from January 1995 to April 2017, for studies comparing both short- and long-term outcomes in younger and elderly patients undergoing liver resection for CRLM. Results: Eleven studies comparing patients aged <70 years with patients aged >70 years and 4 studies comparing patients aged <75 years with patients aged >75 years were included. Postoperative morbidity was similar in patients aged >70 years (27 vs. 30%; p = 0.35) but higher in patients aged >75 years (21 vs. 32%; p = 0.001). Postoperative mortality was higher in both patients aged >70 years (2 vs. 4%; p = 0.01) and in patients aged >75 years (1 vs. 6%; p = 0.02). Mean 5-year overall survival was lower in patients aged >70 years (40 vs. 32%; p < 0.001) but equal in patients aged >75 years (42 vs. 32%; p = 0.06). Conclusion: Although postoperative morbidity and mortality were increased with higher age, liver resection for CRLM seems justified in selected elderly patients.

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