scholarly journals Prognosis of the combination therapy results in patients with synchronous metastases of colorectal cancer

2019 ◽  
Vol 4 (3) ◽  
pp. 60-64
Author(s):  
S. V Kozlov ◽  
O. I Kaganov ◽  
A. A Moryatov ◽  
A. M Kozlov ◽  
A. P Borisov
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Cytoreductive Surgery ◽  
Thermal Ablation ◽  
Combined Treatment ◽  
Stage Iv ◽  
Radiofrequency Thermal Ablation ◽  
Mutational Status ◽  
Synchronous Metastases ◽  
Metastatic Liver

Objectives - to optimize the indications for radiofrequency thermal ablation in patients with synchronous multiple metastases of colorectal cancer to the liver on the basis of prognostic treatment results. Material and methods. The study group included 78 patients with colorectal cancer with synchronous multiple bilobar liver metastases, who have underwent combined treatment in the period of 2007- 2015, such as cytoreductive surgery removing the primary intestinal tumor in combination with RFA of metastases in the liver, followed by chemotherapy. Results. A computer program for preoperative risk assessment of disease progression was developed and introduced in clinical practice. It is based on the results of the analysis of the factors, predicting the risk of relapse during the first year after cytoreductive surgery with RFA of synchronous multiple CRC liver metastases. Conclusion. The index of metastatic liver damage (the product of the sum of the diameters of metastatic liver lesions by their number), the mutational status of the KRAS gene, CEA values are significant factors in predicting the progression of the disease, which can optimize indications for radiofrequency thermal ablation in the treatment of patients with stage IV CRC with synchronous metastases to the liver.

scholarly journals The Results of Cytoreductive Operations in Patients with Colorectal Cancer with Simultaneous Liver Polymetastases

2018 ◽  
Vol 3 (2) ◽  
pp. 54-59
Author(s):  
SV V Kozlov ◽  
OI I Kaganov ◽  
AE E Orlov ◽  
AM M Kozlov
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Liver Metastases ◽  
Cytoreductive Surgery ◽  
Stage Iv ◽  
Long Term Results ◽  
Control Group ◽  
Results Of Treatment ◽  
Cytoreductive Treatment

Aim - to improve the long-term results of cytoreductive treatment of patients with simultaneous multiple bilobar liver metastases of colorectal cancer by the use of RFTA. Materials and methods. The study presents the results of treatment of 168 patients diagnosed with colorectal cancer of stage IV with simultaneous bilobar metastases in the liver. In the main group, cytoreductive tumor removal was accompanied by radiofrequency thermal ablation (RFTA) of metastatic formations. In the control group only the primary tumor was removed. Results. The use of RFTA during cytoreductive surgery does not worsen the immediate results of surgical treatment, in comparison with patients, where the effect on liver metastases has not been performed, but allows to increase medians of uneventful and overall survival from 9 and 22 months to 17 and 29 months, respectively. Conclusions. The use of RFTA for simultaneous multiple bilobar metastases in the liver during cytoreductive surgery makes it possible to achieve 22.7% of the three-year uneventfulness and 4.3% of the five-year overall survival.

scholarly journals Local Control by Radiofrequency Thermal Ablation Increased Overall Survival in Patients With Refractory Liver Metastases of Colorectal Cancer

Medicine ◽  
2016 ◽  
Vol 95 (14) ◽  
pp. e3338 ◽  
Author(s):  
Po-Chih Yang ◽  
Been-Ren Lin ◽  
Yi-Chang Chen ◽  
Yu-Lin Lin ◽  
Hong-Shiee Lai ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Liver Metastases ◽  
Local Control ◽  
Thermal Ablation ◽  
Radiofrequency Thermal Ablation

scholarly journals Occlusion of the vein adjacent to colorectal cancer liver metastasis as a way to increase the radicality of percutaneous radiofrequency thermal ablation

2021 ◽  
pp. 57-63
Author(s):  
K. L. Murashko ◽  
A. M. Yurkovskiy
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastasis ◽  
Liver Metastases ◽  
Lower Incidence ◽  
Thermal Ablation ◽  
Heat Removal ◽  
Residual Tumor ◽  
Control Group ◽  
Colorectal Cancer Liver Metastasis ◽  
Radiofrequency Thermal Ablation

Objective. To evaluate the effectiveness of preoperative coagulation of the vein adjacent to a tumor nodule in sonographically-guided percutaneous radiofrequency thermal ablation of perivascular liver metastases of colorectal cancer.Materials and methods. To address the issue, we compared the results of sonographically-guided percutaneous radiofrequency thermal ablation of perivascular liver metastases of colorectal cancer in 27 patients (aged 60.5 (58; 68) years) without prior coagulation of the adjacent vein (control group) and 26 patients (62.0 (60; 74)) with prior coagulation of the adjacent vein (experimental group).Results. Lower incidence of residual tumor in the ablation area in the patients with prior coagulation of the adjacent vein (14.3 % vs. 29 % of the patients in the control group) and a higher relapse-free survival of such patients (65.2 % vs. 53.6 % and 55.6 % vs. 33.3 %) were reported as compared to the group without prior coagulation of the adjacent vein (after 6 and 12 months, respectively).Conclusion. Preoperative coagulation of the vein adjacent to colorectal cancer liver metastasis allows reducing the effect of heat removal from the RFA zone, thereby contributing to higher radicality of the treatment and resulting both in a lower incidence of residual tumor in the ablation zone and a higher relapse-free survivalof patients, notably without signifcant concomitant changes in the affected part of the liver (segment atrophy).

Radiofrequency Thermal Ablation of Metastatic Liver Tumors: Usefulness of Combined Chemotherapy

2001 ◽  
Vol 45 (2) ◽  
pp. 147
Author(s):  
Jeong Nam Heo ◽  
Hyun Chul Rhim ◽  
Yong Soo Kim ◽  
Byung Hee Koh ◽  
On Koo Cho ◽  
...  
Keyword(s):  
Thermal Ablation ◽  
Liver Tumors ◽  
Combined Chemotherapy ◽  
Radiofrequency Thermal Ablation ◽  
Metastatic Liver Tumors ◽  
Metastatic Liver

scholarly journals Complications Following Irinotecan-Loaded Microsphere Chemoembolization of Colorectal Metastatic Liver Lesions Associated with Hepatic-Artery Branch Temporary Stasis

2021 ◽  
Vol 28 (3) ◽  
pp. 2296-2307
Author(s):  
Marcin Szemitko ◽  
Elzbieta Golubinska-Szemitko ◽  
Jerzy Sienko ◽  
Aleksander Falkowski
Keyword(s):  
Colorectal Cancer ◽  
Adverse Events ◽  
Liver Metastases ◽  
Hepatic Artery ◽  
Liver Lesions ◽  
Apparent Lack ◽  
Neoplastic Lesion ◽  
Hepatic Artery Branch ◽  
Artery Branch ◽  
Metastatic Liver

Chemoembolization with irinotecan-loaded microspheres has proven effective in the treatment of unresectable liver metastases in the course of colorectal cancer (CRC). Most researchers recommend slowly administering the embolizate at the level of the lobar arteries, without obtaining visible stasis. However, there are reports of a relationship between postoperative embolizate retention in metastatic lesions and the response to treatment. To retain residual embolizate throughout the entire neoplastic lesion requires a temporary flow stop (stasis) within all supply vessels, which may cause temporary stasis in subsegmental or even segmental vessels. Objective: To assess the risk of complications and post-embolization syndrome severity following chemoembolization of CRC metastatic liver lesions with microspheres loaded with Irinotecan, with regard to hepatic-artery branch level of temporary stasis. Patients and methods: The study included 52 patients (29 female, 23 male) with liver metastases from CRC, who underwent 202 chemoembolization treatments (mean: 3.88 per patient) with microspheres loaded with 100 mg irinotecan. Postembolization syndrome (PES) severity and complication occurrence were assessed with regard to the hepatic-artery branch level of temporary stasis. Adverse events were assessed according to Cancer Therapy Evaluation Program Common Terminology Criteria for Adverse Events. Results: Median survival from the start of chemoembolization was 13 months. From 202 chemoembolization sessions, 15 (7.4%) significant complications were found. The study found a significant relationship between the branch level of temporary stasis and the presence of complications (p < 0.001), with the highest number of complications observed with temporary stasis in segmental vessels. PES was diagnosed after 103 (51%) chemoembolization treatments. A significant association was found between PES severity and the branch level of temporary stasis (p < 0.001). Conclusions: The branch level of temporary stasis affected the severity of post-embolization syndrome. A significant association was found between the branch level of temporary stasis obtained in chemoembolization procedures and the presence of complications. The apparent lack of change in numbers of complications when stasis was applied at tumor supply vessels or subsegmental arteries may indicate the safe use of temporary stasis in some cases where colorectal cancer metastases are treated. Further research is needed to determine the most effective chemoembolization technique.

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