scholarly journals Child-Turcotte-Pugh Score as a Predictive Factor for Long-Term Survival After Repeat Hepatectomy for Recurrent Liver Metastases of Colorectal Cancer

2021 ◽  
Vol 105 (1-3) ◽  
pp. 611-618
Author(s):  
Jun Woo Bong ◽  
Younuk Joo ◽  
Jihyun Seo ◽  
Sang Hee Kang ◽  
Sun Il Lee ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Liver Function ◽  
Liver Metastases ◽  
Repeat Hepatectomy ◽  
Term Survival ◽  
Long Term Survival ◽  
Initial Hepatectomy ◽  
Significant Difference

Objective We aimed to evaluate the changes in liver function after repeat hepatectomy and their relationship with survival of patient with colorectal cancer. Summary of Background Data Repeat hepatectomy has been accepted as an effective treatment for recurrent liver metastases; however, how repeat hepatectomy changes the liver function during the follow-up period is not well understood. Methods Data regarding patients underwent R0 resections at initial hepatectomy for colorectal cancer with liver metastasis from 2012 to 2017 were retrospectively reviewed. Patients were divided into groups according to the total number of hepatectomies. Overall survival and Child-Turcotte-Pugh score after hepatectomy were analyzed. Results Fifty-three patients underwent single hepatectomy and 37 patients underwent repeat hepatectomy. There was no significant difference in the overall survival rates between the 2 groups. At 27 months after the initial hepatectomy, mean Child-Turcotte-Pugh scores of patients with repeat hepatectomy started to become statistically higher than those of patients with single hepatectomy. Overall survival of patients who survived after 27 months from the initial hepatectomy showed a statistical difference between the 2 groups. The total number of liver metastases ≥ 4 and Child-Turcotte-Pugh score ≥ 6 at 27 months after the initial hepatectomy were significant risk factors for overall survival of patient who survived after 27 months from the initial hepatectomy. Conclusions Liver function after repeat hepatectomy can be deteriorated after a long-term period. Careful approach and continuous assessment of the liver function after hepatectomy are necessary to maintain long-term survival after repeat hepatectomy.

scholarly journals O-0030 Long Term Survival Data from EORTC Study 40983: Perioperative Chemotherapy for Resectable Liver Metastases from Colorectal Cancer

2012 ◽  
Vol 23 ◽  
pp. iv18
Author(s):  
Bernard Nordlinger ◽  
Halfdan Sorbye ◽  
Bengt Glimelius ◽  
Graeme John Poston ◽  
Peter M. Schlag ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Survival Data ◽  
Perioperative Chemotherapy ◽  
Term Survival ◽  
Long Term Survival

T Cell Infiltrate Predicts Long-Term Survival Following Resection of Colorectal Cancer Liver Metastases

2009 ◽  
Vol 16 (9) ◽  
pp. 2524-2530 ◽  
Author(s):  
Steven C. Katz ◽  
Venu Pillarisetty ◽  
Zubin M. Bamboat ◽  
Jinru Shia ◽  
Cyrus Hedvat ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
T Cell ◽  
Liver Metastases ◽  
Cell Infiltrate ◽  
Colorectal Cancer Liver Metastases ◽  
Term Survival ◽  
Long Term Survival

New Trends in the Surgical Treatment of Colorectal Cancer Liver Metastases

1998 ◽  
Vol 84 (3) ◽  
pp. 281-288 ◽  
Author(s):  
Steven A. Curley ◽  
Rosario Vecchio
Keyword(s):  
Colorectal Cancer ◽  
Surgical Treatment ◽  
Liver Resection ◽  
Liver Metastases ◽  
Colorectal Cancer Liver Metastases ◽  
Term Survival ◽  
Long Term Survival ◽  
Cancer Metastases ◽  
Colorectal Cancer Metastases

Colorectal cancer is one of the most common solid tumors affecting people around the world. A significant proportion of patients with colorectal cancer will develop or will present with liver metastases. In some of these patients, the liver is the only site of metastatic disease. Thus, surgical treatment approaches are an appropriate and important treatment option in patients with liver-only colorectal cancer metastases. Resection of colorectal cancer liver metastases can produce long-term survival in selected patients, but the efficacy of liver resection as a solitary treatment is limited by two factors. First, a minority of patients with liver metastases have resectable disease. Second, the majority of patients who undergo successful liver resection for colorectal cancer metastases develop recurrent disease in the liver, extrahepatic sites, or both. In this paper, in addition to the results of liver resection for colorectal cancer metastases, we will review the results of cryoablation, heat ablation, and hepatic arterial chemotherapy using a surgically implanted pump. Each of these surgical treatment modalities can produce long-term survival in a subset of patients with liver-only colorectal cancer metastases, whereas systemic chemotherapy used alone rarely results in long-term survival in these patients. While surgical treatments provide the best chance for long-term survival or, in some cases, the best palliation in patients with colorectal cancer liver metastases, it is clear that further improvements in patient outcome will require multimodality therapy regimens.

The Role of Liver Transplantation for Liver Metastasis from Colorectal Cancer

2020 ◽  
Vol 04 (01) ◽  
pp. 013-018
Author(s):  
Koji Tomiyama ◽  
M. Katherine Dokus ◽  
Jennie Errigo ◽  
Marie Laryea ◽  
Roberto Hernandez-Alejandro
Keyword(s):  
Colorectal Cancer ◽  
Liver Transplantation ◽  
Liver Metastases ◽  
Surgical Resection ◽  
Liver Volume ◽  
Remnant Liver ◽  
Colorectal Cancer Liver Metastases ◽  
Term Survival ◽  
Long Term Survival

AbstractAs chemotherapy for colorectal cancer becomes effective for extending long-term survival, its liver metastases (colorectal cancer liver metastases [CRCLM]) are considered as the progression that best defines patient survival. Surgical resection is the most effective and only curative treatment for CRCLM. Although advancement in liver surgery to increase resectability of CRCLM has borne fruit, there are still limitations, namely tumor burden, remnant liver volume, and chemotherapy-related liver damage. CRCLM used to be considered a contraindication for liver transplantation (LTx) based on preliminary experience in the early era of LTx. Recent advancement in chemotherapy and surgical resection for CRCLM as well as improved outcome of LTx have attracted interest in revisiting this old dogma of LTx for CRCLM. Preliminary experience from Norway has shown promising results and potential for long-term survival with LTx. In this article, we review the history of LTx for CRCLM, rationale for revisiting the concept, early experience from Norway and discuss the issues around and future perspectives on LTx for CRCLM.

Surgical microwave ablation of otherwise non-resectable colorectal cancer liver metastases: Expanding opportunities for long term survival

2021 ◽  
Vol 36 ◽  
pp. 61-64
Author(s):  
Kendall R. McEachron ◽  
Jacob S. Ankeny ◽  
Alexandria Robbins ◽  
Ariella M. Altman ◽  
Schelomo Marmor ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Microwave Ablation ◽  
Colorectal Cancer Liver Metastases ◽  
Term Survival ◽  
Long Term Survival

Comparison of long-term survival outcomes of operative versus nonoperative management of recurrent rectal cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14132-e14132
Author(s):  
Aneel Bhangu ◽  
Mohammed Ali ◽  
David Cunningham ◽  
Gina Brown ◽  
Paris P Tekkis
Keyword(s):  
Rectal Cancer ◽  
Overall Survival ◽  
Recurrent Rectal Cancer ◽  
Survival Outcomes ◽  
R0 Resection ◽  
Term Survival ◽  
Long Term Survival ◽  
Primary Surgery ◽  
Significant Difference

e14132 Background: Complete surgical resection is considered the best treatment for recurrent rectal cancer (RRC). The aim of the study was to compare survival outcomes from operative and non-operative patients presenting with RRC. Methods: Patients with RRC whose management was discussed by a tertiary referral specialist multidisciplinary team between January 2007 and August 2011 were identified from a prospectively maintained database. The primary endpoint was 5-year overall survival estimated by Kaplan-Meier survival method. Results: Of 127 patients with RRC, 105 were isolated to the pelvis and 22 were associated with distant disease at presentation. From the time of primary surgery to first recurrence, 1, 3, 5 and 10-year local recurrence rates were 22%, 72%, 85% and 96% respectively. Of 70 patients (55%, 70/127) who underwent pelvic resection of recurrence, 64% underwent R0, 20% R1 and 16% R2 resections. Corresponding 5-year overall survival was R0: 60%, R1: 42% and R2: 0% (log-rank p=0.004). There was no significant difference in survival between R2 resection and those managed non-operatively (hazard ratio 0.738, 95% confidence interval 0.341-1.600, p=0.559). Five year disease-free survival was 53% with R0 resection and 30% with R1 resection. Conclusions: Most recurrences occur within 5 years of primary surgery, although some occur up to 10 years later. R0 resection is the treatment of choice that leads to long-term survival and is suitable as an early surrogate marker for long-term survival. There was no survival benefit of R2 resection over non-resected recurrences.

scholarly journals P-OGC82 Length of stay in hospital as a prognostic tool for post-esophagectomy survival

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Catherine Jenn Yi Cheang ◽  
Pradeep Patil
Keyword(s):  
Overall Survival ◽  
Length Of Stay ◽  
Performance Indicator ◽  
Statistical Significance ◽  
Care Practice ◽  
Complication Rates ◽  
Term Survival ◽  
Long Term Survival ◽  
Significant Difference

Abstract Background Length of stay (LOS) after oesophagectomy is an indicator of efficiency of patient care, practice style, complication rates and their management. Median LOS in specialist centres is 10 to 12 days. The desired LOS as a quality performance indicator (QPI) has recently been reduced from 21 days to 14 days in our country. The aim of this study was to see if this change in LOS could be validated by differences in long term outcomes. Methods A total of 110 consecutive patients who underwent esophagectomy for cancer between 2011 and 2020 were included in this study. We compared the statistical significance in overall survival of patients with LOS 14 days and 21 days as two separate datasets. Overall survival (OS) in months was calculated from date of surgery to death or otherwise censored. 4 patients who died in hospital were excluded. Statistical analysis was conducted using IBM SPSSv25. Results 110 consecutive patients were included in this study. The median postoperative stay for all patients was 18 days with an interquartile range of 14 to 26 days. Kaplan Meier survival comparison with Log Rank of OS with LOS 21 days showed no difference in survival between patients with LOS ≤ 21 days and LOS > 21 days (p = 0.487). A similar comparison showed a statistically significant difference in survival in patients with LOS≤ 14 days and LOS > 14 days (p = 0.034), with a mean survival (months) of 80.9 and 60.2 respectively. Conclusions LOS after surgery is a marker of patient health, care efficiency and uncomplicated recovery. No clear LOS with patient benefits has been defined in the past. A LOS of 14 days after oesophagectomy in our cohort is interestingly an indicator and predictor of long-term survival. Further subgroup analysis of patient and tumour characteristics are being carried out to see if we can predict patients who can be discharged in less than 14 days. These characteristics can then be used to predict and study long term survival after oesophagectomy.

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