scholarly journals Impact of Metformin Use on Survival in Patients Undergoing Liver Resection for Colorectal Cancer Metastases

2021 ◽  
pp. 000313482110604
Author(s):  
Christof Kaltenmeier ◽  
Brittany Morocco ◽  
Hamza Yazdani ◽  
Katherine Reitz ◽  
Kelley Meyer ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Univariate Analysis ◽  
Hepatic Metastases ◽  
Stage Iv ◽  
Epidemiological Studies ◽  
Hepatic Recurrence ◽  
Stage Iv Colorectal Cancer ◽  
Cancer Metastases ◽  
Vast Literature ◽  
Colorectal Cancer Metastases

Introduction Resection of colorectal liver metastases provides the best chance for survival in patients with Stage IV colorectal cancer; however, hepatic recurrence is frequent and the main cause of death. Multiple epidemiological studies have documented an association between metformin and anti-neoplastic effects in a variety of cancers. Given the vast literature, we evaluated the incidence on recurrence and survival of patients on metformin who undergo surgery for colorectal liver metastasis (CRLM). Methods We selected 270 consecutive patients with known CRLM who underwent hepatic metastases resection at our institution between January 1st 2012 and December 31st 2019. Patients were divided based on their use of metformin (n = 62) or no metformin (n = 208). Adjusted analysis of recurrence-free (RFS) and overall survival (OS) was performed. Results Patients on metformin had significantly longer RFS (HR: .44, 95% CI: .26-.75, P < .002; Median RFS: 49 months vs 33 months) and OS (HR .60, 95% CI .31-.97, P < .048, Median OS: 72 months vs 60 months). Additional factors associated with shorter RFS on univariate analysis included the following: CEA > 200 ng/ml (HR: 2.23, 95% CI 1.21-4.03, P < .010), positive liver margin (HR: 3.70, 95% CI 2.27-6.03, P < .001), and >1 tumor (HR: 1.98, 95% CI 1.26-3.09, P < .003). Liver margin remained a significant factor for predicting shorter OS (HR: 4.99, 95% CI 2.49-10.0, P < .001). Conclusion In this study, we found that patients with CRLM on metformin have prolonged RFS and OS postliver resection. Further prospective randomized trials need to be carried out to evaluate the anti-neoplastic effect of metformin in diabetic and non-diabetic cancer patients.

Surgical Treatment of Colorectal Cancer Liver Metastases

2012 ◽  
pp. 209-212
Author(s):  
Steven A. Curley
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Treatment Strategies ◽  
Stage Iv ◽  
Hepatic Arterial Infusion ◽  
Arterial Infusion ◽  
Colorectal Cancer Liver Metastases ◽  
Stage Iv Colorectal Cancer ◽  
Cancer Metastases ◽  
Colorectal Cancer Metastases

Overview: Treatment strategies for patients with stage IV colorectal cancer have changed markedly in the last decade. Patients with colorectal cancer metastases to the liver have always been a fascinating group to consider biologically and for local-regional treatment strategies. In the late 1980s through the 1990s, resection was performed for a select subset of patients who had resectable disease. However, a high proportion of patients had bilobar unresectable disease and were treated with either 5-fluorouracil–based systemic chemotherapy or implanted hepatic arterial infusion pumps. The advent of the new millennium was associated with the availability of several new cytotoxic and biologic agents active in colorectal cancer. These agents have completely changed the approach to the treatment of patients with colorectal cancer liver metastases and thus have increased the complexity of the decision-making process for treatment of these patients.

scholarly journals Perspectives on Hepatic Metastases and the Minimally Invasive Approach to Resection

EMJ Oncology ◽  
2021 ◽  
pp. 53-61
Author(s):  
Elroy Patrick Weledji
Keyword(s):  
Colorectal Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Liver Metastases ◽  
Invasive Surgery ◽  
Colorectal Liver Metastases ◽  
Hepatic Metastases ◽  
Stage Iv ◽  
Invasive Approach ◽  
Stage Iv Colorectal Cancer

Surgical resection is the most effective treatment approach in colorectal liver metastases. The improved survival in Stage IV colorectal cancer is associated with a better diagnosis and evaluation, proper decision-making, improved chemotherapy, and the adoption of parenchymal-sparing hepatic resections. Liver surgery was one of the last frontiers reached by minimally invasive surgery. Surgical techniques and specialised equipment evolved to overcome the technical limitations, making laparoscopic liver resections safe and feasible. The aetiology and pathophysiology of hepatic metastases are discussed along with the rationale for and efficacy of minimally invasive surgery for colorectal liver metastases. Improved imaging techniques, identification of genomic markers, advances in chemotherapy, and personalised therapy will further improve the outcome of minimally invasive surgery in the management of Stage IV colorectal cancer.

Eight years after introducing liver resection at the Oncology Institute of Vojvodina

2013 ◽  
Vol 21 (3-4) ◽  
pp. 101-104
Author(s):  
Ivan Majdevac ◽  
Nikola Budisin ◽  
Milan Ranisavljevic ◽  
Dejan Lukic ◽  
Imre Lovas ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Resection ◽  
Liver Tumors ◽  
Liver Parenchyma ◽  
Malignant Neoplasms ◽  
Chemotherapy Treatment ◽  
Primary Liver Tumors ◽  
Cancer Metastases ◽  
Colorectal Cancer Metastases ◽  
Medical Histories

Background: Hepatectomies are mostly performed for the treatment of hepatic benign or malignant neoplasms, intrahepatic gallstones, or parasitic cysts of the liver. The most common malignant neoplasms of the liver are metastases from colorectal cancer. Anatomic liver resection involves two or more hepatic segments, while non-anatomic liver resection involves resection of the metastases with a margin of uninvolved tissue. The aim of this manuscript was to show results of hepatectomies performed at the Oncology Institute of Vojvodina. Methods: We performed 133 liver resections from January 1997 to December 2013. Clinical and histopathological data were obtained from operative protocols, histopathological reports, and patients? medical histories. Results: We did 80 metastasectomies, 51 segmentectomies, and 18 radiofrequent ablations (RFA). Average number of colorectal cancer metastases was 1.67 per patient. We also made 10 left hepatectomies. In all cases, we made non-anatomic resections. Conclusion: Decision about anatomic versus non-anatomic resections for colorectal metastasis and primary liver tumors should be made before surgical exploration. Preservation of liver parenchyma is important with respect to liver failure and postoperative chemotherapy treatment.

Laparoscopic surgery for palliative resection of the primary tumor in incurable stage IV colorectal cancer

2012 ◽  
Vol 26 (11) ◽  
pp. 3201-3206 ◽  
Author(s):  
Hideaki Nishigori ◽  
Masaaki Ito ◽  
Yuji Nishizawa ◽  
Atsushi Kohyama ◽  
Takamaru Koda ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Primary Tumor ◽  
Stage Iv ◽  
Palliative Resection ◽  
Stage Iv Colorectal Cancer

Non-operative management of the primary tumour in patients with incurable stage IV colorectal cancer

2001 ◽  
Vol 88 (10) ◽  
pp. 1352-1356 ◽  
Author(s):  
A. I. Sarela ◽  
J. A. Guthrie ◽  
M. T. Seymour ◽  
E. Ride ◽  
P. J. Guillou ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Primary Tumour ◽  
Stage Iv ◽  
Operative Management ◽  
Stage Iv Colorectal Cancer ◽  
Non Operative Management

scholarly journals Transarterial Radioembolization of Hepatocellular Carcinoma, Liver-Dominant Hepatic Colorectal Cancer Metastases, and Cholangiocarcinoma Using Yttrium90 Microspheres: Eight-Year Single-Center Real-Life Experience

Diagnostics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 122
Author(s):  
Julie Pellegrinelli ◽  
Olivier Chevallier ◽  
Sylvain Manfredi ◽  
Inna Dygai-Cochet ◽  
Claire Tabouret-Viaud ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Hepatocellular Carcinoma ◽  
Liver Tumors ◽  
Progression Free Survival ◽  
Single Center ◽  
Free Survival ◽  
Risk Of Death ◽  
Transarterial Radioembolization ◽  
Cancer Metastases ◽  
Colorectal Cancer Metastases

Liver tumors are common and may be unamenable to surgery or ablative treatments. Consequently, other treatments have been devised. To assess the safety and efficacy of transarterial radioembolization (TARE) with Yttrium-90 for hepatocellular carcinoma (HCC), liver-dominant hepatic colorectal cancer metastases (mCRC), and cholangiocarcinoma (CCA), performed according to current recommendations, we conducted a single-center retrospective study in 70 patients treated with TARE (HCC, n = 44; mCRC, n = 20; CCA, n = 6). Safety and toxicity were assessed using the National Cancer Institute Common Terminology Criteria. Treatment response was evaluated every 3 months on imaging studies using Response Evaluation Criteria in Solid Tumors (RECIST) or mRECIST criteria. Overall survival and progression-free survival were estimated using the Kaplan-Meier method. The median delivered dose was 1.6 GBq, with SIR-Spheres® or TheraSphere® microspheres. TARE-related grade 3 adverse events affected 17.1% of patients. Median follow-up was 32.1 months. Median progression-free survival was 5.6 months and median overall time from TARE to death was 16.1 months and was significantly shorter in men. Progression-free survival was significantly longer in women (HR, 0.49; 95%CI, 0.26–0.90; p = 0.031). Risk of death or progression increased with the number of systemic chemotherapy lines. TARE can be safe and effective in patients with intermediate- or advanced-stage HCC, CCA, or mCRC refractory or intolerant to appropriate treatments.

Management of Patients with Malignant Bowel Obstruction and Stage IV Colorectal Cancer

2011 ◽  
Vol 14 (7) ◽  
pp. 822-828 ◽  
Author(s):  
Kimberly Moore Dalal ◽  
Marc J. Gollub ◽  
Thomas J. Miner ◽  
W. Douglas Wong ◽  
Hans Gerdes ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Bowel Obstruction ◽  
Stage Iv ◽  
Malignant Bowel Obstruction ◽  
Stage Iv Colorectal Cancer
Sign in / Sign up

Export Citation Format

Share Document