Single-center multidisciplinary management of patients with colorectal cancer and resectable synchronous liver metastases improves outcomes
| Autor: | Michael D. Kluger, Daniel Cherqui, Luca Viganò, Perrine Goyer, Daniel Azoulay, Alain Luciani, Mehdi Karoui, Alexis Laurent |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Colorectal cancer medicine.medical_treatment Single Center Metastasis medicine Hepatectomy Humans Stage (cooking) Referral and Consultation Aged Retrospective Studies Aged 80 and over Patient Care Team Chemotherapy Hepatology business.industry Liver Neoplasms Gastroenterology Middle Aged medicine.disease Primary tumor Surgery Treatment Outcome Female Decision process business Colorectal Neoplasms |
| Zdroj: | Clinics and research in hepatology and gastroenterology. 37(1) |
| ISSN: | 2210-741X |
| Popis: | Management of patients with synchronous liver metastasis (SLM) is complex and the surgical decision process should be based on a comprehensive oncological strategy. The aim of the study was to compare outcome of single-center management of patients with colorectal cancer (CRC) and resectable SLM to those of referred patients for liver resection only after removal of their primary tumor (PT).Between 2000 and 2007, 47 patients with CRC and SLM underwent resection of both the PT and metastases under our care (unicentric) and 32 were referred after resection of their PT.The two groups were comparable for demographics, PT and metastatic disease data. In unicentric group, 23% received upfront chemotherapy with the PT in place, 53% had a combined CRC and SLM resection, 11% had a two-stage hepatectomy with resection of the primary during the first stage and 36% underwent delayed hepatectomy. The number of surgical interventions, the delay between diagnosis and liver resection (9 vs. 5 months, P0.001), the median number of cycles of chemotherapy before hepatectomy (12 vs. 6 months, P0.001) were significantly higher in the referred group. Postoperative morbidity was significantly higher in the referred group (75 vs. 47%, P = 0.023). The median follow-up was 43 months. OS and DFS were not significantly different between the two groups.Although the survival benefit is not proven, single-center management of patients with CRC and resectable SLM reduces the number of interventions, the number of cycles of chemotherapy and postoperative morbidity. |
| Databáze: | OpenAIRE |
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