scholarly journals A case of repeat hepatectomy for liver metastasis from solid pseudopapillary neoplasm of the pancreas: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Atsushi Morito ◽  
Kojiro Eto ◽  
Kozue Matsuishi ◽  
Hirokazu Hamasaki ◽  
Keisuke Morita ◽  
...  
Keyword(s):  
Liver Metastasis ◽  
Liver Metastases ◽  
Distal Pancreatectomy ◽  
Treatment Guidelines ◽  
Histopathological Examination ◽  
Repeat Hepatectomy ◽  
R0 Resection ◽  
Solid Pseudopapillary Neoplasm ◽  
Long Term Prognosis

Abstract Background Solid pseudopapillary neoplasm of the pancreas is a rare tumor in young women, metastasizing in only 5–15% of cases, and most commonly to the liver. Although treatment guidelines have not been established, surgical resection is usually performed. We report a rare case of repeat hepatectomy for liver metastases after distal pancreatectomy with solid pseudopapillary neoplasm. Case presentation The patient was a 71-year-old woman who underwent distal pancreatectomy for solid pseudopapillary neoplasm, and liver metastasis occurred 4 years after the first surgery. Partial liver resection was performed for four liver metastases, and histopathological examination revealed a diagnosis of liver metastasis from solid pseudopapillary neoplasm. However, 18 months later, liver metastases were detected again; three tumors were identified, and partial resection was performed, which has provided 18 months’ recurrence-free survival. Conclusions Long-term prognosis can be expected following R0 resection for resectable liver metastasis from solid pseudopapillary neoplasm.

scholarly journals Radiofrequency ablation versus traditional liver resection and chemotherapy for liver metastases from gastric cancer

2020 ◽  
Vol 48 (7) ◽  
pp. 030006052094050
Author(s):  
Kezhong Tang ◽  
Bo Zhang ◽  
Linping Dong ◽  
Lantian Wang ◽  
Zhe Tang
Keyword(s):  
Gastric Cancer ◽  
Radiofrequency Ablation ◽  
Liver Resection ◽  
Liver Metastasis ◽  
Liver Metastases ◽  
Statistical Significance ◽  
Local Treatment ◽  
Long Term Outcomes ◽  
Short And Long Term

Objective To compare the short- and long-term outcomes of radiofrequency ablation (RFA) versus liver resection and chemotherapy for liver metastases from gastric cancer. Methods We retrospectively evaluated 50 patients who underwent curative gastrectomy and local treatments for liver metastases (RFA, n = 20; liver resection, n = 20; and chemotherapy, n = 10) from 2008 to 2018. Results The short- and long-term outcomes of each local treatment were evaluated. The median overall survival (OS) after RFA was similar to that after liver resection (20 vs. 20 months, respectively) and longer than that after chemotherapy (20 vs. 10 months, respectively). The 3-year OS and progression-free survival (PFS) rates after RFA were 20% and 10%, respectively, while those in the liver resection group were 23.5% and 23.5%, respectively. The 3-year OS rate after chemotherapy was 10%. The size and number of metastases were prognostic factors for patients with gastric cancer with liver metastasis without statistical significance. Conclusions Among patients with liver metastasis from gastric cancer, OS and PFS were satisfactory and comparable between RFA and liver resection but better than those of chemotherapy. RFA is an appropriate option for patients with gastric cancer who have a solitary liver metastasis measuring ≤3.0 cm.

scholarly journals A Potential Mechanism of Tumor Progression during Systemic Infections Via the Hepatocyte Growth Factor (HGF)/c-Met Signaling Pathway

2020 ◽  
Vol 9 (7) ◽  
pp. 2074 ◽  
Author(s):  
Hironori Tsujimoto ◽  
Hiroyuki Horiguchi ◽  
Yusuke Matsumoto ◽  
Risa Takahata ◽  
Nariyoshi Shinomiya ◽  
...  
Keyword(s):  
Growth Factor ◽  
Liver Metastasis ◽  
Hepatocyte Growth Factor ◽  
Liver Metastases ◽  
Signaling Pathway ◽  
Tumor Cells ◽  
High Serum ◽  
Term Survival ◽  
Hepatocyte Growth

Background: Increasing evidence has demonstrated that postoperative infectious complications (PICs) after digestive surgery are significantly associated with negative long-term outcomes; however, precise mechanisms of how PICs affect the poor long-term survival remain unclear. Here, we focused on the hepatocyte growth factor (HGF)/c-Met signaling pathway as one of those mechanisms. Methods: In the clinical setting, serum HGF levels were measured in the patients with sepsis and those with PICs after undergoing esophagectomy. Using a liver metastasis mouse model with cecal ligation and puncture (CLP), expressions of HGF and the roles of the HGF/c-Met pathway in the progression of tumor cells were examined. Results: Serum HGF levels were very high in the patients with intra-abdominal infection on postoperative days (PODs) 1, 3, and 5; similarly, compared to the patients without PICs, those with PICs had significantly higher serum HGF levels on 1, 3, and 5 days after esophagectomy. The patients with PICs showed poorer overall survival than those without PICs, and the patients with high serum HGF levels on POD 3 showed poorer prognosis than those with low HGF levels. Similarly, at 24 and 72 h after operation, serum levels of HGF in CLP mice were significantly higher than those in sham-operated mice. Intraperitoneal injection of mouse recombinant HGF significantly promoted liver metastases in sham-operated mice on 14 days after surgery. Knocking down c-Met expression on NL17 tumor cells by RNAi technology significantly inhibited the promotion of CLP-induced liver metastases. Conclusions: Infections after surgery increased serum HGF levels in the clinical as well as experimental settings. Induction of high serum HGF levels by CLP promoted liver metastases in a murine liver metastasis model, suggesting the involvement of the HGF/c-Met signaling pathway in tumor promotion mechanisms. Thus, targeting the HGF/c-Met signaling pathway may be a promising approach for malignant tumors, particularly in the patients with PICs.

Meta-Analysis of Long-Term Outcomes in Patients with Colorectal Liver Metastases Undergoing Hepatectomy with or without Radiofrequency Ablation

2018 ◽  
Vol 84 (12) ◽  
pp. 1913-1923
Author(s):  
Li Long ◽  
Li Wei ◽  
Wu Hong
Keyword(s):  
Radiofrequency Ablation ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Medical Subject Headings ◽  
Long Term Outcomes ◽  
Hazard Ratios ◽  
Long Term Prognosis

This meta-analysis aimed to compare the long-term prognosis of patients with colorectal liver metastases undergoing liver resection (LR) with or without radiofrequency ablation (RFA). A systematic search was performed using both medical subject headings and truncated word searches to identify all comparative studies published on this topic. The primary outcomes were postoperative overall survival (OS) and disease-free survival (DFS). Pooled hazard ratios (HR) with 95 per cent confidence intervals (95% CI) were calculated. A total of 10 studies which included 3900 patients were finally enrolled in the meta-analysis. Patients treated by LR gained better OS (HR: 2.07, 95% CI: 1.82–2.37) and DFS (HR: 1.91, 95% CI: 1.70–2.15) than those patients treated by LR 1 RFA, after pooling unadjusted HRs from the 10 studies. Five studies provided the data of adjusted HR. The pooled results showed that patients in the LR 1 RFA group had shorter OS (HR: 1.66, 95% CI: 1.18–2.32, P = 0.004) but similar DFS (HR: 1.36, 95% CI: 0.99–1.88) compared with patients in the LR group. Our meta-analysis showed that colorectal liver metastases patients who underwent LR gained better long-term outcomes compared with patients undergoing LR 1 RFA. However, after adjusting confounders, LR 1 RFA achieved comparable DFS with LR alone.

Cetuximab and chemotherapy in the treatment of patients with initially “nonresectable” colorectal (CRC) liver metastases: Long-term follow-up of the CELIM trial.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 3538-3538 ◽  
Author(s):  
Gunnar Folprecht ◽  
Thomas Gruenberger ◽  
Wolf Bechstein ◽  
Hans-Rudolf Raab ◽  
Juergen Weitz ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Tumor Response ◽  
Progression Free Survival ◽  
R0 Resection ◽  
Term Survival ◽  
Free Survival ◽  
Long Term Follow Up ◽  
Clinical Trial Information

3538 Background: CRC liver metastases can be resected after downsizing with intensive chemotherapy schedules, with a strong correlation between the response and resection rates. Cetuximab plus chemotherapy has been shown to increase the rates of tumor response and resection of liver metastases. (Van Cutsem et al, JCO 2011). Methods: Patients (pts) with technically non-resectable and/or with > 4 liver metastases were randomized to treatment with FOLFOX/cetuximab (arm A) or FOLFIRI/cetuximab (arm B) and evaluated regarding resectability every 2 months. Resection was offered to all patients who became resectable during the study. K-ras and b-raf status were retrospectively evaluated. Data on tumor response and resection were reported earlier (Folprecht et al, Lancet Oncol 2010). Overall and progression free survival were analyzed in December 2012. Results: Between Dec 2004 and March 2008, 56 pts were randomized to arm A, 55 to arm B. For the current analysis, 109 pts were evaluable for overall survival (OS), and 106 patients for PFS. The median OS was 35.7 [95% CI: 27.2-44.2] months (arm A: 35.8 [28.1-43.6], arm B: 29.0 [16.0-41.9], HR 1.03 [0.66-1.61], p=0.9). The median PFS was 10.8 [9.3-12.2] months (Arm A: 11.2 [7.2-15.3], Arm B: 10.5 [8.9-12.2], HR 1.18 [0.79-1.74], p=0.4). Patients with R0 resection had a better OS (median: 53.9 [35.9-71.9] mo) than patients without R0 resection (27.3 [21.1-33.4] mo, p=0.002) and a better PFS (median 15.4 [11.4-19.5] and 8.9 [6.7-11.1] mo in R0 resected and not R0 resected pts, p<0.001). The 5 year survival in R0 resected patients is 46.2% [29.5-62.9%]. Conclusions: This study confirmed a favourable long term survival of patients with initially “nonresectable” CRC liver metastases treated in a multidisciplinary approach of neoadjuvant chemotherapy with cetuximab and subsequent metastasectomy in pts who became resectable. Clinical trial information: NCT00153998. [Table: see text]

scholarly journals A metastatic colorectal carcinoma: A curative approach?

2014 ◽  
Vol 61 (2) ◽  
pp. 47-49
Author(s):  
Nadezda Basara
Keyword(s):  
Liver Metastasis ◽  
Liver Metastases ◽  
Colorectal Liver Metastasis ◽  
Randomised Trial ◽  
Increase Response Rate ◽  
Term Survival ◽  
Exon 2 ◽  
Long Term Survival ◽  
Response To Chemotherapy

Background: Unresectable colorectal liver metastases can be resected after response to chemotherapy. The use of neoadjuvant chemotherapy with or without targeted monoclonal antibodies increases the proportion of resectable liver metastasis and conferred a long term survival of 40%. Methods: The current ongoing studies regarding neodjuvant treatment strategies aiming to increase a proportion of patients with resectable liver metastases is going to be presented. Results: Perioperative chemotherapy with FOLFOX4 is compatible with major liver surgery and reduces the risk of events of progression free survival in resected patients. The results of the CELIM study confirm a favourable long-term survival for patients with initially suboptimal or unresectable colorectal liver metastasis who respond to conversion therapy and undergo secondary resection. The New EPOC randomised trial does not support the addition of cetuximab to chemotherapy and surgery for operable colorectal liver metastasis in KRAS exon 2 wild-type patients. Conclusion: The ability of anti-epidermal growth factor receptor agents to increase response rate and resection when added to chemotherapy has been clearly shown in a number of trials. The resection rates are higher with chemotherapy plus Cetuximab, in general, a conversion is contributes to the better overall survival.

scholarly journals Examination of The Characteristics of Long-Term Survivors Among Patients With Gallbladder Cancer With Liver Metastasis Who Underwent Surgical Treatment: A Retrospective Multicenter Study (ACRoS1406)

2022 ◽  
Author(s):  
Ryota Higuchi ◽  
Hiroaki Ono ◽  
Ryusei Matsuyama ◽  
Yusuke Takemura ◽  
Shinjiro Kobayashi ◽  
...  
Keyword(s):  
Overall Survival ◽  
Liver Metastasis ◽  
Liver Metastases ◽  
Gallbladder Cancer ◽  
Complete Resection ◽  
Hazard Ratio ◽  
Negative Margin ◽  
Long Term Survivors ◽  
Retrospective Multicenter Study

Abstract Background: Gallbladder cancer (GBC) with liver metastasis is considered unresectable. However, there have been infrequent reports of long-term survival in patients with GBC and liver metastases. Therefore, we examined the characteristics of long-term survivors of gallbladder cancer with liver metastasis.Methods: A retrospective multicenter study of 503 patients with GBC (mean age, 68.6 years; female, 52%) was performed. Although patients with pre-operatively diagnosed GBC and liver metastasis were generally excluded from resection, some cases identified during surgery were resected.Result: In patients with resected stage III/IV GBC (n = 228), the period 2007–2013 (vs. 2000–2006, hazard ratio 0.55), other type histology (vs. well/moderate histology, hazard ratio 2.34), ≥2 liver metastases (vs. one liver metastasis, hazard ratio 4.30), and positive margin resection (vs. complete resection with a negative margin, hazard ratio 1.57) were independent prognostic factors for overall survival, whereas one liver metastasis (vs. no liver metastasis) was not. The 5-year overall survival and median survival times in those with one liver metastasis with complete resection and a negative margin (40.9%, 28.3 months) were significantly better than those in patients with ≥2 liver metastases with complete resection and a negative margin (0%, 11.0 months, p = 0.025), and comparable to those in patients with liver metastasis with complete resection and a negative margin (37.0%, 33.0 months). According to the univariate analysis of resected patients with GBC and liver metastases (n=24), minor hepatectomy, less blood loss, less surgery time, papillary adenocarcinoma, T2, morbidity of Clavien–Dindo classification ≤ 2, and adjuvant chemotherapy were significantly associated with longer survival. Long-term survivors (n = 5) had a high frequency of T2 tumors (4/5), had small liver metastases near the gallbladder during or after surgery, underwent minor hepatectomy without post-operative complications, and received post-operative adjuvant chemotherapy.Conclusions: Although there is no surgical indication for GBC with liver metastasis diagnosed pre-operatively, minor hepatectomy and post-operative chemotherapy may be an option for selected patients with T2 GBC and liver metastasis identified during or after surgery who do not have other poor prognostic factors.

scholarly journals Expression of cyclooxygenase-2 in gastric cancer and its relation to liver metastasis and long-term prognosis

2005 ◽  
Vol 11 (31) ◽  
pp. 4908 ◽  
Author(s):  
Ji-Ren Yu ◽  
Yi-Jun Wu ◽  
Qi Qin ◽  
Ke-Zheng Lu ◽  
Sheng Yan ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Liver Metastasis ◽  
Cyclooxygenase 2 ◽  
Long Term Prognosis

scholarly journals Laparoscopic Distal Pancreatectomy of a Solid Pseudopapillary Tumor (SPT) Achieves Long-Term Oncologic Safety and Multiorgan Preservation

2019 ◽  
Vol 07 (01) ◽  
pp. e58-e62
Author(s):  
Ahmed ElHaddad ◽  
Paolo Gasparella ◽  
Christoph Castellani ◽  
Georg Singer ◽  
Erich Sorantin ◽  
...  
Keyword(s):  
Distal Pancreatectomy ◽  
Histopathological Examination ◽  
Laparoscopic Approach ◽  
Solid Pseudopapillary Tumor ◽  
Low Grade ◽  
Cancer Antigen 125 ◽  
Pancreatic Tail ◽  
Oncological Safety

AbstractThe oncological safety of a laparoscopic approach for solid pseudopapillary tumors (SPTs) of the pancreas remains a matter of debate. We present the long-term follow-up of an adolescent girl with an SPT in the pancreatic tail. A multimodality workup including magnetic resonance imaging (MRI) revealed a complex, spherical mass of 4.4 cm × 3.6 cm × 4 cm most likely located in the pancreatic tail. All routine laboratory investigations and tumor markers were within normal limits (alpha fetoprotein [AFP], cancer antigen 125 [CA125], CA 19–9, carcinoembryonic antigen [CEA], adrenocorticotropic hormone [ACTH]). Diagnostic laparoscopy was performed to verify the origin of the tumor in the pancreatic tail. In a three-port technique the tumor was mobilized of the splenic vessels until a distal pancreatectomy could be completed. Histopathological examination confirmed the complete resection of a low-grade malignant SPT. The postoperative course was unremarkable. Regular pediatric oncological follow-up examinations for 3 years, including MRI every 6 months, ruled out recurrence and confirmed preservation of splenic and pancreatic functions. While data about the technical feasibility of a laparoscopic approach to pancreatic SPT are already available, this pediatric case report adds a long-term oncological and functional success to the available literature.

scholarly journals Perioperative Chemotherapy for Liver Metastasis of Colorectal Cancer

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3535
Author(s):  
Gloria Chan ◽  
Cheng E. Chee
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastasis ◽  
Liver Metastases ◽  
Patient Selection ◽  
Systemic Therapy ◽  
Clinicopathological Features ◽  
Risk Scores ◽  
Perioperative Chemotherapy ◽  
Isolated Liver

The liver is the dominant site of metastasis for patients with colorectal cancer. For those with isolated liver metastases, surgical resection with systemic therapy has led to long-term remission in as high as 80% of patients in well-selected cohorts. This review will focus on how systemic therapy should be integrated with resection of liver metastases; in particular, the use of clinical risk scores based on clinicopathological features that help with patient selection, various approaches to the treatment of micro-metastatic disease (peri-operative versus post-operative chemotherapy), as well as conversion chemotherapy for those with initially upfront unresectable disease will be discussed.

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