Feasibility and Short-Term Outcomes in Liver-First Approach: A Spanish Snapshot Study (the RENACI Project).

Autor:	Serradilla-Martín M; Department of Surgery, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain.; Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain.; Department of Surgery, School of Medicine, University of Granada, 18016 Granada, Spain., Villodre C; Department of Surgery, Hospital General Universitario Dr. Balmis, 03010 Alicante, Spain.; ISABIAL, Instituto de Investigación Sanitaria y Biomédica de Alicante, 03010 Alicante, Spain.; Department of Surgery, Universidad Miguel Hernández, 03202 Alicante, Spain., Falgueras-Verdaguer L; Department of Surgery, Hospital Universitario Dr. Josep Trueta, 17007 Girona, Spain., Zambudio-Carroll N; Department of Surgery, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain., Castell-Gómez JT; Department of Surgery, Hospital Universitario La Paz, 28046 Madrid, Spain., Blas-Laina JL; Department of Surgery, Hospital Royo Villanova, 50015 Zaragoza, Spain., Borrego-Estella V; Department of Surgery, Hospital Universitario Lozano Blesa, 50009 Zaragoza, Spain., Domingo-Del-Pozo C; Department of Surgery, Hospital Universitario Dr. Peset, 46017 Valencia, Spain., García-Plaza G; Department of Surgery, Hospital Universitario Insular, 35016 Las Palmas de Gran Canaria, Spain., González-Rodríguez FJ; Department of Surgery, Hospital Clínico Universitario de Santiago, 15706 Santiago de Compostela, Spain., Montalvá-Orón EM; Department of Surgery, Hospital Universitario y Politécnico La Fe, IIS La Fe, Ciberehd ISCIII, 46026 Valencia, Spain., Moya-Herraiz Á; Department of Surgery, Hospital Universitario de Castellón, 12004 Castelló de la Plana, Spain., Paterna-López S; Department of Surgery, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain., Suárez-Muñoz MA; Department of Surgery, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain., Alkorta-Zuloaga M; Department of Surgery, Hospital Universitario Donostia, 20014 San Sebastián, Spain., Blanco-Fernández G; Department of Surgery, Hospital Universitario de Badajoz, 06006 Badajoz, Spain., Dabán-Collado E; Department of Surgery, Hospital Universitario San Cecilio, 18016 Granada, Spain., Gómez-Bravo MA; Department of Surgery, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain., Miota-de-Llamas JI; Department of Surgery, Hospital Universitario de Albacete, 02006 Albacete, Spain., Rotellar F; Department of Surgery, Clínica Universidad de Navarra, 31008 Pamplona, Spain., Sánchez-Pérez B; Department of Surgery, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain., Sánchez-Cabús S; Department of Surgery, Hospital Universitario de la Santa Creu i Sant Pau, 08041 Barcelona, Spain., Pacheco-Sánchez D; Department of Surgery, Hospital Universitario Río Hortega, 47012 Valladolid, Spain., Rodríguez-Sanjuan JC; Department of Surgery, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain., Varona-Bosque MA; Department of Surgery, Hospital Universitario Nuestra Señora de la Candelaria, 38010 Santa Cruz de Tenerife, Spain., Carrión-Álvarez L; Department of Surgery, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain., de la Serna-Esteban S; Department of Surgery, Hospital Clínico Universitario, 28040 Madrid, Spain., Dopazo C; Department of Surgery, Hospital Universitario Vall d'Hebron, 08035 Barcelona, Spain., Martín-Pérez E; Department of Surgery, Hospital Universitario La Princesa, 28006 Madrid, Spain., Martínez-Cecilia D; Department of Surgery, Hospital Universitario La Princesa, 28006 Madrid, Spain.; Department of Surgery, Hospital Universitario Virgen de la Salud, 45004 Toledo, Spain., Castro-Santiago MJ; Department of Surgery, Hospital Universitario Puerta del Mar, 11009 Cádiz, Spain., Dorcaratto D; Department of Surgery, Hospital Clínico Universitario, 46010 Valencia, Spain., Gutiérrez-Díaz ML; Department of Surgery, Hospital Quirón, 50006 Zaragoza, Spain., Asencio-Pascual JM; Department of Surgery, Hospital Universitario Gregorio Marañón, 28007 Madrid, Spain., Burdío-Pinilla F; Department of Surgery, Hospital Universitario del Mar, 08003 Barcelona, Spain., Carracedo-Iglesias R; Department of Surgery, Hospital Universitario Álvaro Cunqueiro, 36312 Vigo, Spain., Escartín-Arias A; Department of Surgery, Hospital Universitario Arnau de Vilanova, 25198 Lleida, Spain., Ielpo B; Department of Surgery, Hospital Universitario del Mar, 08003 Barcelona, Spain.; Department of Surgery, Hospital Universitario de León, 24008 León, Spain., Rodríguez-Laiz G; Department of Surgery, Hospital General Universitario Dr. Balmis, 03010 Alicante, Spain., Valdivieso-López A; Department of Surgery, Hospital Universitario de Cruces, 48903 Barakaldo, Spain., De-Vicente-López E; Department of Surgery, Hospital Universitario HM Sanchinarro, 28050 Madrid, Spain., Alonso-Orduña V; Department of Medical Oncology, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain., Ramia JM; Department of Surgery, Hospital General Universitario Dr. Balmis, 03010 Alicante, Spain.; ISABIAL, Instituto de Investigación Sanitaria y Biomédica de Alicante, 03010 Alicante, Spain.; Department of Surgery, Universidad Miguel Hernández, 03202 Alicante, Spain.
Jazyk:	angličtina
Zdroj:	Cancers [Cancers (Basel)] 2024 Apr 26; Vol. 16 (9). Date of Electronic Publication: 2024 Apr 26.
DOI:	10.3390/cancers16091676
Abstrakt:	(1) Background: The liver-first approach may be indicated for colorectal cancer patients with synchronous liver metastases to whom preoperative chemotherapy opens a potential window in which liver resection may be undertaken. This study aims to present the data of feasibility and short-term outcomes in the liver-first approach. (2) Methods: A prospective observational study was performed in Spanish hospitals that had a medium/high-volume of HPB surgeries from 1 June 2019 to 31 August 2020. (3) Results: In total, 40 hospitals participated, including a total of 2288 hepatectomies, 1350 for colorectal liver metastases, 150 of them (11.1%) using the liver-first approach, 63 (42.0%) in hospitals performing <50 hepatectomies/year. The proportion of patients as ASA III was significantly higher in centers performing ≥50 hepatectomies/year (difference: 18.9%; p = 0.0213). In 81.1% of the cases, the primary tumor was in the rectum or sigmoid colon. In total, 40% of the patients underwent major hepatectomies. The surgical approach was open surgery in 87 (58.0%) patients. Resection margins were R0 in 78.5% of the patients. In total, 40 (26.7%) patients had complications after the liver resection and 36 (27.3%) had complications after the primary resection. One-hundred and thirty-two (89.3%) patients completed the therapeutic regime. (4) Conclusions: There were no differences in the surgical outcomes between the centers performing <50 and ≥50 hepatectomies/year. Further analysis evaluating factors associated with clinical outcomes and determining the best candidates for this approach will be subsequently conducted.
Databáze:	MEDLINE
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