How to reduce the risk of recurrence after surgical treatment of colorectal liver metastases?

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 544-544
Author(s):  
L. Benhaim ◽  
D. Goárá ◽  
S. Bonnet ◽  
F. Dumont ◽  
D. Malka ◽  
...  
Keyword(s):  
High Risk ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Systemic Chemotherapy ◽  
Recurrence Free Survival ◽  
Curative Intent ◽  
Technical Problems ◽  
Free Survival ◽  
Hepatic Recurrence ◽  
Liver Recurrence

544 Background: After surgery with curative intent for colorectal liver metastases (MHCCR), liver recurrence occurs in more than 60% of patients, despite the administration of adjuvant systemic chemotherapy. The objective of this study was to compare the prognosis of patients operated on MHCCR with high risk of recurrences in the liver, treated by postoperative chemotherapy hepatic arterial infusion (HAI) by oxaliplatin, to that obtained after adjuvant systemic chemotherapy. Methods: From January 2000 to December 2009, 113 patients who underwent curative resection of more than 3 MHCCR, were selected from a prospective database. Among these 113 patients, 47 had received postoperative HAI associated with systemic chemotherapy (HAI+) and 66, systemic chemotherapy alone (HAI-). Results: The two groups were comparable in age, sex, stage of primary, rates of synchronous (> 75%), and bilobar (> 90%) MHCCR. The number of MHCCR was significantly higher in the group HAI+ (p < 0.0001). Twenty-seven patients (57%) received more than 6 courses of HAI. HAI was discontinued in 6 patients (12%) due to technical problems with the catheter. After a median follow up of 75 months (7-125), the overall survival and recurrence-free survival at 5 years were higher for patients HAI+ compared to those HAI-, respectively 52.9% vs. 12.3% (p = 0.06) and 30.8% vs. 2% (p < 0.0001). Conclusions: The postoperative administration of oxaliplatin-based HAI associated to systemic chemotherapy after cure of MHCCR, improves recurrence-free survival of patients at high risk of hepatic recurrence, compared to systemic chemotherapy alone. No significant financial relationships to disclose.

scholarly journals Primary tumor location affects recurrence-free survival for patients with colorectal liver metastases after hepatectomy: A propensity score matching analysis

2020 ◽  
Author(s):  
Yuanping Zhang ◽  
Yongjin Wang ◽  
Yichuan Yuan ◽  
Jiliang Qiu ◽  
Yuxiong Qiu ◽  
...  
Keyword(s):  
Propensity Score ◽  
Liver Metastases ◽  
Primary Tumor ◽  
Colorectal Liver Metastases ◽  
Tumor Location ◽  
Recurrence Free Survival ◽  
Primary Tumors ◽  
Free Survival ◽  
Primary Tumor Location ◽  
Before And After

Abstract Background: Whether primary tumor location of colorectal cancer (CRC) affects survival of patients after resection of liver metastases remains controversial. This study was conducted to investigate the differences in clinicopathological characteristics and prognosis between right-sided CRC and left-sided CRC patients with liver metastases after hepatectomy. Methods: From 2002 to 2018, 611 patients with colorectal liver metastases (CRLM) who underwent hepatectomy at our center were reviewed. Primary tumors located from cecum to transverse colon were defined as right-sided group (n = 141); tumors located from splenic flexure to rectum were defined as left-sided group (n = 470). Patients were compared between two groups before and after a 1:1 propensity score matching (PSM) analysis. Results: Before PSM, median survival time and 5-year overall survival (OS) rate in right-sided group were 77 months and 56.3%, and those in left-sided group were 64 months and 51.1%, respectively. After PSM, median survival time and 5-year OS rate in right-sided group were 77 months and 55.9%, and those in left-sided group were 58.8 months and 47.3%, respectively. The OS rates did not differ between two groups before and after PSM (P = 0.575; P = 0.453). However, significant different recurrence-free survival (RFS) rate was found before and after PSM between right-sided and left-sided group (P = 0.028, P = 0.003). Conclusions: Compared to patients with left-sided primary tumors, patients with right-sided primary tumors had a worse RFS but similar OS. Careful preoperative evaluation, intensive preoperative chemotherapy and frequent follow-up to detect early recurrence might be justified for CRLM patients with right-sided primary tumors.

scholarly journals Conditional Recurrence-Free Survival after Resection of Colorectal Liver Metastases: Persistent Deleterious Association with RAS and TP53 Co-Mutation

2019 ◽  
Vol 229 (3) ◽  
pp. 286-294.e1 ◽  
Author(s):  
Yoshikuni Kawaguchi ◽  
Heather A. Lillemoe ◽  
Elena Panettieri ◽  
Yun Shin Chun ◽  
Ching-Wei D Tzeng ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Recurrence Free Survival ◽  
Free Survival

scholarly journals METACHRONOUS COLORECTAL LIVER METASTASES HAS BETTER PROGNOSIS - IS IT TRUE?

2018 ◽  
Vol 55 (3) ◽  
pp. 258-263 ◽  
Author(s):  
Claudemiro QUIREZE JUNIOR ◽  
Andressa Machado Santana BRASIL ◽  
Lúcio Kenny MORAIS ◽  
Edmond Raymond Le CAMPION ◽  
Eliseu José Fleury TAVEIRA ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Liver Metastases ◽  
Hepatic Metastasis ◽  
Colorectal Liver Metastases ◽  
Public Health Problem ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
The Mean ◽  
Colorectal Hepatic Metastasis

ABSTRACT BACKGROUND: Liver metastases from colorectal cancer are an important public health problem due to the increasing incidence of colorectal cancer worldwide. Synchronous colorectal liver metastasis has been associated with worse survival, but this prognosis is controversial. OBJECTIVE: The objective of this study was to evaluate the recurrence-free survival and overall survival between groups of patients with metachronous and synchronous colorectal hepatic metastasis. METHODS: This was a retrospective analysis of medical records of patients with colorectal liver metastases seen from 2013 to 2016, divided into a metachronous and a synchronous group. The Cox regression model and the Kaplan-Meier method with log-rank test were used to compare survival between groups. RESULTS: The mean recurrence-free survival was 9.75 months and 50% at 1 year in the metachronous group and 19.73 months and 63.3% at 1 year in the synchronous group. The mean overall survival was 20.00 months and 6.2% at 3 years in the metachronous group and 30.39 months and 31.6% at 3 years in the synchronous group. Patients with metachronous hepatic metastasis presented worse overall survival in multivariate analysis. The use of biological drugs combined with chemotherapy was related to the best overall survival prognosis. CONCLUSION: Metachronous colorectal hepatic metastasis was associated with a worse prognosis for overall survival. There was no difference in recurrence-free survival between metachronous and synchronous metastases.

Hepatic resection of initially unresectable liver metastases from colorectal cancer after hepatic arterial infusion of oxaliplatin and systemic 5-fluorouracil and leucovorin

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e15015-e15015
Author(s):  
D. Goere ◽  
I. Dsehais ◽  
T. de Baere ◽  
V. Boige ◽  
D. Malka ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Systemic Chemotherapy ◽  
Disease Free Survival ◽  
Hepatic Arterial Infusion ◽  
Morbidity Rate ◽  
Hepatic Artery Infusion ◽  
Arterial Infusion ◽  
Technical Problems ◽  
Hepatic Recurrence

e15015 Background: About 80% of patients (pts) presenting colorectal liver metastases (CRLM) are initially unresectable. A subgroup will become eligible for surgery after chemotherapy administration. Efficacy of hepatic arterial infusion (HAI) of oxaliplatin with systemic 5-Fluorouracil and leucovorin (LV5FU2) in with unresectable CRLM was previously demonstrated. This study was performed to evaluate the resection rate of pts with initially unresectable CRLM after oxaliplatin HAI and systemic LV5FU2. Methods: Patients treated in our hospital with oxaliplatin HAI and systemic LV5FU2 for unresectable CRLM from May 1999 to May 2007 were analyzed. Inclusion criteria were : unresectable CRLM, no extensive extrahepatic disease, HAI performed in our hospital, minimal follow up of 24 months. Eighty-seven pts were selected from a prospective database Results: Hepatic arterial infusion was delivered after previous systemic chemotherapy failure in 69 pts (80%). Main criterion for unresectability was massive liver involvement (80%). CRLM were synchronous and bilateral in respectively 85% and 90% of pts. The median number of oxaliplatin HAI cycles was 8 (0- 25). Thirty-one pts experienced technical problems with the arterial catheter, which was responsible for HAI withdrawal in seven. A total of 23 pts (26.4%) were operated, leading to resection and/or radiofrequency ablation of CRLM in 21 pts. No post-operative mortality was observed and the morbidity rate was 30%. The 3-year overall survival for patients operated was 72.5% versus 12% for non operated pts (p<0.0001). After a median follow-up of 75 months [24–118], intra-hepatic recurrence occurred in 10 pts. Conclusions: Hepatic artery infusion of oxaliplatin and systemic LV5FU2 increase the resectability rate in pts with advance CRLM even after previous systemic chemotherapy failure. Future studies combining oxaliplatin HAI and recent IV chemotherapy are needing to achieve an increase disease-free survival. No significant financial relationships to disclose.

scholarly journals Histologically Verified Biliary Invasion was Associated with Impaired Liver Recurrence-Free Survival in Resected Colorectal Cancer Liver Metastases

2018 ◽  
Vol 108 (3) ◽  
pp. 201-209 ◽  
Author(s):  
P. Reijonen ◽  
P. Österlund ◽  
H. Isoniemi ◽  
J. Arola ◽  
A. Nordin
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Liver Metastasis ◽  
Liver Metastases ◽  
Recurrence Free Survival ◽  
Colorectal Cancer Liver Metastases ◽  
Free Survival ◽  
Colorectal Cancer Liver Metastasis ◽  
Liver Recurrence ◽  
Disease Free

Background and Aims: The impact of biliary invasion on recurrence and survival, after resection of colorectal cancer liver metastases, is not well known as publications are limited to small patient series. The aim was to investigate if biliary invasion in liver resected patients associated with liver relapses and recurrence-free survival. Secondary endpoints included association with other prognostic factors, disease-free survival and overall survival. Materials and Methods: All patients with histologically verified biliary invasion (n = 31, 9%) were identified among 344 patients with liver resection between January 2009 and March 2015. Controls (n = 78) were selected from the same time period and matched for, among others, size and number of colorectal cancer liver metastasis. Results: Median liver recurrence-free survival was significantly shorter in patients with biliary invasion than in controls (15.3 months versus not reached; p = 0.031) and more relapses were noted in the liver (61.3% versus 33.3%; p = 0.010), respectively. In univariate analyses for liver recurrence-free survival, biliary invasion was the only significant prognostic factor; p = 0.034. There were no statistical differences in disease-free and overall survival between the groups. Conclusion: Biliary invasion was associated with higher liver recurrence rates and shorter liver recurrence-free survival in patients with resected colorectal cancer liver metastasis.

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