The therapeutic effect of radiofrequency ablation(RFA) combining with/without chemotherapy in treating inoperable liver metastases of colorectal cancers

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 13581-13581
Author(s):  
H. Pan ◽  
S. Wang ◽  
Y. Zheng ◽  
W. Jin
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Median Time ◽  
Therapeutic Effect ◽  
Median Survival ◽  
Survival Rates ◽  
Colorectal Cancers ◽  
Primary Tumors ◽  
Local Progression

13581 Background: Patients (pts) with colorectal cancer often develop metastases to the liver without extra hepatic spread. Surgery is the mainstay of treatment in these pts, but only 20% of pts are suitable for a surgical approach and some pts are reluctant to receive surgery. This study is to compare the therapeutic effect of RFA combining with chemotherapy and RFA alone in treating inoperable liver metastases of colorectal cancers. Methods: From May 2001 to July 2005, 26 patients have inoperable liver metastases derived from colorectal cancer whose primary tumors were resected. Among them, 14 pts received chemotherapy from 3 months before RFA to 3 months after RFA (13 pts received systemic chemotherapy with FOLFOX4, 1 pt received FOLFIRI), 12 pts didn’t receive any chemotherapy. The metastatic lesions in liver were evaluated by CT scan every 3 months. Results: Pts’ characteristics: m/f 18/8; median age 57 yrs (range, 31–68); primary tumor: colon 15, rectum 11; karnofsky’s score≥60. Median no. of LM: 2.2 (range, 1–7), mean size of LM: 24mm (range, 12–97 mm). The last time of follow-up visit is Nov 2005, 11 pts has been dead because of tumor progression, 14 pts is still living, and 1 patient is lost to follow-up. The main complication of RFA is fever, local pain and elevation of hepatic enzyme. Reactive pleural effusion occurred in 1 patient which disappeared after thoracentesis. No RFA related bleeding,pneumathorax,perforation of digestive tract,infection and needle track implantation occurred. The median survival,1-year survival rates and 2-year survival rates in all pts were 33 months, 83.8% and 64.1% respectively. The median time to local progression in all pts is 346 days. In the pts treated with RFA alone, the median survival,1-year survival rates and 2-year survival rates were 18 months, 71.3% and 38.2% respectively; in the pts treated with RFA and chemotherapy, they were 36.5 months, 92.9% and 85.1% respectively (P=0.0210). In the pts treated with RFA alone, the median time to local progression is 346 days; in the pts treated with RFA and chemotherapy, it is 317 days (P>0.05). Conclusions: RFA Combining with chemotherapy is safe and may be more effective than RFA alone in treating inoperable liver metastases of colorectal cancer. No significant financial relationships to disclose.

scholarly journals Is repeated pulmonary metastasectomy justified?

2020 ◽  
Vol 37 (6) ◽  
pp. 675-682 ◽  
Author(s):  
Céline Forster ◽  
Amaya Ojanguren ◽  
Jean Yannis Perentes ◽  
Matthieu Zellweger ◽  
Sara Federici ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Survival Rate ◽  
Pulmonary Resection ◽  
Cox Regression ◽  
Survival Rates ◽  
Pulmonary Metastasectomy ◽  
Primary Tumors ◽  
Operative Morbidity ◽  
Operative Outcomes

AbstractRecurrence after pulmonary metastasectomy (PM) is frequent, but it is unclear to whom repeated pulmonary metastasectomy (RPM) offers highest benefits. Retrospective analysis of oncological and post-operative outcomes of consecutive patients who underwent PM from 2003 to 2018. Overall survival (OS) and disease-free interval (DFI) were calculated. Cox regression was used to identify variables influencing OS and DFI. In total, 264 patients (female/male: 114/150; median age: 62 years) underwent PM for colorectal cancer (32%), sarcoma (19%), melanoma (16%) and other primary tumors (33%). Pulmonary metastasectomy was approached by video-assisted thoracic surgery (VATS) in 73% and pulmonary resection was realized by non-anatomical resection in 76% of cases. The overall median follow-up time was 33 months (IQR 16–56 months) and overall 5-year survival rate was 62%. Local or distant recurrences were observed in 172 patients (65%) and RPM could be performed in 66 patients (25%) for a total of 116 procedures. RPM was realized by VATS in 49% and pulmonary resection by wedge in 77% of cases. In RPM patients, the 5-year survival rate after first PM was 79%. Post-operative cardio-pulmonary complication rate (13% vs. 12%; p = 0.8) and median length of stay (4 vs. 5 days; p = 0.2) were not statistically different between first PM and RPM. Colorectal cancer (HR 0.56), metachronous metastasis (HR 0.48) and RPM (HR 0.5) were associated with better survival. In conclusion, our results suggest that RPM offers favorable survival rates without increasing post-operative morbidity.

scholarly journals Second primary malignancies in colorectal cancer patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jana Halamkova ◽  
Tomas Kazda ◽  
Lucie Pehalova ◽  
Roman Gonec ◽  
Sarka Kozakova ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Median Time ◽  
Cancer Diagnosis ◽  
Second Primary ◽  
Early Stage Disease ◽  
Primary Tumors ◽  
Second Primary Malignancies ◽  
Colorectal Cancer Patients

AbstractThe prevalence of second primary malignancies (SPMs) in the western world is continually increasing with the risk of a new primary cancer in patients with previously diagnosed carcinoma at about 20%. The aim of this retrospective analysis is to identify SPMs in colorectal cancer patients in a single-institution cohort, describe the most frequent SPMs in colorectal cancer patients, and discover the time period to occurrence of second primary tumors. We identified 1174 patients diagnosed with colorectal cancer in the period 2003–2013, with follow-up till 31.12.2018, and median follow-up of 10.1 years, (median age 63 years, 724 men). A second primary neoplasm was diagnosed in 234 patients (19.9%). Older age patients, those with early-stage disease and those with no relapse have a higher risk of secondary cancer development. The median time from cancer diagnosis to development of CRC was 8.9 years for breast cancer and 3.4 years for prostate cancer. For the most common cancer diagnosis after primary CRC, the median time to development was 0–5.2 years, depending on the type of malignancy. Patients with a diagnosis of breast, prostate, or kidney cancer, or melanoma should be regularly screened for CRC. CRC patients should also be screened for additional CRC as well as cancers of the breast, prostate, kidney, and bladder. The screening of cancer patients for the most frequent malignancies along with systematic patient education in this field should be the standard of surveillance for colorectal cancer patients.

scholarly journals Cytoreductive approach to peritoneal carcinomatosis originated from colorectal cancer: Turkish experience

2006 ◽  
Vol 53 (2) ◽  
pp. 17-21 ◽  
Author(s):  
Mehmet Füzün ◽  
Selman Sökmen ◽  
Cem Terzi ◽  
Aras Emre-Canda
Keyword(s):  
Colorectal Cancer ◽  
Lymph Nodes ◽  
Liver Metastases ◽  
Peritoneal Carcinomatosis ◽  
Survival Time ◽  
Median Survival ◽  
Intraperitoneal Chemotherapy ◽  
Survival Rates ◽  
Complete Cytoreduction ◽  
Mean Survival Time

Peritoneal carcinomatosis (PC) in contrast to lymph nodes and liver metastases was assumed as a terminal condition with no curative treatment options having a 5 to 9 months median survival rate until recently. Today, in properly selected patients, curative surgical treatment of PC is possible like resection of lymph nodes and liver metastases. Between 1996 and 2005, 29 patients who underwent cytoreductive surgery combined with intraperitoneal chemotherapy for PC originated from colorectal cancer (CRC) were analyzed prospectively at the Department of Surgery in Dokuz Eylul University Hospital. Mean age was 54 year (range, 23-75 years). There was no peroperative mortality in 29 patients. The morbidity rate was 41% (12/29) and 6 (20%) patients required reoperation(s) for major complications. Mean and median survival time was 34 and 21 months, respectively. The overall 1-year, 3-year, and 5-year survival rates were 72%, 13%, and 7%, respectively. Mean survival time was 56 months in patients with peritoneal cancer index (PCI) <10, and 22 months in patients with PCI >10 (P=0.075). The mean survival time was 62 months in patients with complete cytoreduction (CC)-0 score, 21 months in patients with CC-1 score, and 7 months in patients with CC-2 and 3 scores. Patients who had CC-0 score had better survival than patients having CC-1 and CC-2 scores (P = 0.003 and P = 0.000, respectively). Patients who had CC-0 and 1 scores had better survival than patients with CC-2 score (P = 0.000). The overall 1-year, 3-year, and 5-year survival rates for patients with CC-0 score were 87%, 37%, and 25%, respectively. There was a positive correlation between the PCI and CC score (P = 0.001, correlation coefficient = 0.585 with correlation is significant at level 0.01). Cytoreductive approach combined with intraperitoneal chemotherapy and systemic chemotherapy prolongs survival in selected patients with PC of CRC with acceptable morbidity and mortality. Prognosis is better in patients with limited disease and in whom complete cytoreduction is achieved. In patients with PC of CRC, the key issue is to select the patients in whom complete cytoreduction is feasible. Better patient assessment with new diagnostic tools such as (PET)-CT or PET-magnetic resonance imaging will be used to detect more precisely the patients with low tumor burden in the new feature.

Multicenter, randomized, phase III trial comparing radical retropubic prostatectomy with conventional external beam radiotherapy for localized prostate cancer: An interim report

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 4607-4607
Author(s):  
S. M. Di Stasi ◽  
A. Giannantoni ◽  
M. Valenti ◽  
L. Storti ◽  
F. Attisani ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Disease Progression ◽  
Median Time ◽  
External Beam Radiotherapy ◽  
Survival Rates ◽  
Radical Retropubic Prostatectomy ◽  
Localized Prostate Cancer ◽  
Local Progression ◽  
Clinical Disease Progression

4607 Background: We report the outcomes of a randomised trial comparing radical retropubic prostatectomy (RP) with conventional external beam radiotherapy (EBRT) in patients with clinically localized prostate cancer. Methods: Between January 1997 and September 2001, 137 patients with clinically localized diagnosed prostate cancer were randomly assigned to RP (n = 70) or EBRT (n = 67). Data collected at follow-up included evidence of clinical disease progression, survival rates and general and disease specific health-related quality of life. All data were measured by physical examination, digital rectal examination, PSA, annual TC and bone scan and questionnaire. Analysis was by intention to treat. Results: After a median follow-up of 67 months (range 24–88) 35 patients (32.8%) had evidence of biochemical disease progression, 22 (31.4%) in RP group and 23 (32.8%) in EBRT group respectively. The median time to biochemical failure was 55.5 months (range 1–86) in RP group and 56 (range 3–88) in EBRT group. A local progression was observed in 11 patients (15.79%) of RP group and 12 (17.9%) of EBRT group. The median time to local progression was 65 months (range 6–86) in RP group and 64 (range 6–88) in EBRT group. Distant metastases were observed in 4 patients (5.7%) in RP group and 6 (8.9%) in EBRT group. The median time to distant failure was 67 months (range 12–86) in RP group and 66 (range 12–88) in EBRT group. Death due to prostate cancer occurred in 3/70 of patients assigned to RP (4.3%) and in 1/67 of those assigned to EBRT (1.5%). A significant decrease in general HRQOL was evident only in the first month after RP (p < 0.001). At 2 years, patients undergoing RP report significantly worse urinary function (p < 0.001), but better bowel function than those treated with EBRT (p < 0.001). Sexual dysfunction was more prevalent in the RP than in the EBRT group (70.2% versus 61.2%). Conclusions: This interim analysis indicates that there was no significant difference between RP and EBRT in terms of clinical disease progression and survival rates in patients with clinically localized prostate cancer. However, additional larger sample size accrual and long-term follow-up data are warranted to confirm these results. No significant financial relationships to disclose.

scholarly journals Discordance of KRAS Mutational Status between Primary Tumors and Liver Metastases in Colorectal Cancer: Impact on Long-Term Survival Following Radical Resection

Cancers ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 2148
Author(s):  
Francesco Ardito ◽  
Francesco Razionale ◽  
Lisa Salvatore ◽  
Tonia Cenci ◽  
Maria Vellone ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Primary Tumor ◽  
Kras Mutation ◽  
Colorectal Tumor ◽  
Term Survival ◽  
Primary Tumors ◽  
Mutation Status ◽  
Primary Colorectal Tumor ◽  
Kras Mutation Status

If KRAS mutation status of primary colorectal tumor is representative of corresponding colorectal liver metastases (CRLM) mutational pattern, is controversial. Several studies have reported different rates of KRAS discordance, ranging from 4 to 32%. Aim of this study is to assess the incidence of discordance and its impact on overall survival (OS) in a homogenous group of patients. KRAS mutation status was evaluated in 107 patients resected for both primary colorectal tumor and corresponding CRLM at the same institution, between 2007 and 2018. Discordance rate was 15.9%. Its incidence varied according to the time interval between the two mutation analyses (p = 0.025; Pearson correlation = 0.2) and it was significantly higher during the first 6 months from the time of primary tumor evaluation. On multivariable analysis, type of discordance (wild-type in primary tumor, mutation in CRLM) was the strongest predictor of poor OS (p < 0.001). At multivariable logistic regression analysis, the number of CRLM >3 was an independent risk factor for the risk of KRAS discordance associated with the worst prognosis (OR = 4.600; p = 0.047). Results of our study suggested that, in the era of precision medicine, possibility of KRAS discordance should be taken into account within multidisciplinary management of patients with metastatic colorectal cancer.

scholarly journals Clinical Application of CT-Guided Percutaneous Microwave Ablation for the Treatment of Lung Metastasis from Colorectal Cancer

2017 ◽  
Vol 2017 ◽  
pp. 1-9
Author(s):  
Lin Li ◽  
Ketong Wu ◽  
Haiyang Lai ◽  
Bo Zhang
Keyword(s):  
Colorectal Cancer ◽  
Lung Metastasis ◽  
Microwave Ablation ◽  
Progression Free Survival ◽  
Ct Guided ◽  
Metastatic Lesions ◽  
Local Progression ◽  
Invasive Method ◽  
Percutaneous Microwave Ablation

Objective. The aim of our research is to explore the clinical efficacy and safety of CT-guided percutaneous microwave ablation (MWA) for the treatment of lung metastasis from colorectal cancer. Materials and Methods. CT-guided percutaneous MWA was performed in 22 patients (male 14, female 8, mean age: 56.05 ± 12.32 years) with a total of 36 lung metastatic lesions from colorectal cancer between February 2014 and May 2017. Clinical data were retrospectively analyzed with respect to the efficacy, safety, and outcome. Results. Of the 36 lesions, 34 lesions (94.4%) reduced obviously with small cavitations or fibrous stripes formed and had no evidence of recurrence during follow-up. The volume of the other 2 lesions demonstrated local progression after 6 months by follow-up CT. The primary complications included pneumothorax (28%), chest pain (21%), and fever (5%). These symptoms and signs were obviously relieved or disappeared after several-day conservative treatment. The mean follow-up of the patients was 25.54 ± 12.58 months (range 2–41 months). The estimated progression-free survival rate was 94.4%. Conclusion. Our results demonstrate that CT-guided percutaneous MWA appears to be an effective, reliable, and minimally invasive method for the treatment of lung metastasis from colorectal cancer. This trial is registered with ChiCTR-ORC-17012904.

scholarly journals Chemotherapy and target therapy as neo-adjuvant approach for initially unresectable colorectal liver metastases

2012 ◽  
Vol 6 (1) ◽  
pp. 6
Author(s):  
Luigi Rossi ◽  
Angelo Zullo ◽  
Federica Zoratto ◽  
Anselmo Papa ◽  
Martina Strudel ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Cancer Patients ◽  
Target Therapy ◽  
Resection Rate ◽  
Biological Drugs ◽  
Unresectable Colorectal Liver Metastases ◽  
Neo Adjuvant Chemotherapy ◽  
Colorectal Cancer Patients

Although surgery is the most effective treatment for liver metastases in colorectal cancer patients, only 15-20% of these patients are suitable for a radical surgical approach, and metastases recurrence may occur at follow up. In the last decade, the use of pre-operative chemotherapy in combination with new biological drugs has been introduced. We reviewed data of neo-adjuvant chemotherapy strategies aimed at increasing the resection rate of liver metastases in colorectal cancer patients who were initially considered unresectable.

scholarly journals The DNA hypermethylation phenotype of colorectal cancer liver metastases resembles that of the primary colorectal cancers

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Stephany Orjuela ◽  
Mirco Menigatti ◽  
Peter Schraml ◽  
Patryk Kambakamba ◽  
Mark D. Robinson ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Colorectal Cancers ◽  
Dna Hypermethylation ◽  
Colorectal Cancer Liver Metastases

scholarly journals Conversion Chemotherapy With a Modified FLOX Regimen for Borderline or Unresectable Liver Metastases From Colorectal Cancer: An Alternative for Limited-Resources Settings

2019 ◽  
pp. 1-6
Author(s):  
Renata Colombo Bonadio ◽  
Paulo Henrique Amor Divino ◽  
Jorge Santiago Madero Obando ◽  
Karolina Cayres Alvino Lima ◽  
Débora Zachello Recchimuzzi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Median Overall Survival ◽  
Low Cost ◽  
Progression Free Survival ◽  
Hazard Ratio ◽  
R0 Resection ◽  
Free Survival ◽  
Unresectable Liver Metastases

PURPOSE Conversion chemotherapy is often used for borderline or unresectable (B/U) liver metastases from colorectal cancer (CRC) with the aim of achieving resectability. Although intensive and costly regimens are often used, the best regimen in this scenario remains unclear. We aimed to evaluate the outcomes of patients with B/U liver metastases from CRC treated with conversion chemotherapy with the modified fluorouracil, leucovorin, and oxaliplatin (mFLOX) regimen followed by metastasectomy. METHODS We performed a single-center retrospective analysis of patients with B/U liver metastases from CRC treated with chemotherapy with the mFLOX regimen followed by surgery. B/U disease was defined as at least one of the following: more than four lesions, involvement of hepatic artery or portal vein, or involvement of biliary structure. RESULTS Fifty-four consecutive patients who met our criteria for B/U liver metastases were evaluated. Thirty-five patients (64%) had more than four liver lesions, 16 (29%) had key vascular structure involvement, and 16 (29%) had biliary involvement. After chemotherapy, all patients had surgery and 42 (77%) had R0 resection. After a median follow-up of 37.2 months, median progression-free survival (PFS) was 16.9 months and median overall survival (OS) was 68.3 months. R1-R2 resections were associated with worse PFS and OS compared with R0 resection (PFS: hazard ratio, 2.65; P = .007; OS: hazard ratio, 2.90; P = .014). CONCLUSION Treatment of B/U liver metastases from CRC with conversion chemotherapy using mFLOX regimen followed by surgical resection was associated with a high R0 resection rate and favorable survival outcomes. On the basis of our results, we consider mFLOX a low-cost option for conversion chemotherapy among other options that have been proposed.

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