Oncological strategies for locally advanced rectal cancer with synchronous liver metastases, interval strategy versus rectum first strategy: a comparison of short-term outcomes
| Autor: | Pere Planellas, Antoni Codina-Cazador, N. Gómez-Romeu, Emilio Ramos, H. Salvador-Rosés, Santiago López-Ben, Margarida Casellas-Robert, Ramon Farrés, Juan Figueras |
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| Rok vydání: | 2017 |
| Předmět: |
Liver surgery
Male Cancer Research medicine.medical_specialty Colorectal cancer Locally advanced Rectum 030230 surgery Complete resection Resection 03 medical and health sciences 0302 clinical medicine medicine Hepatectomy Humans Prospective Studies Aged Aged 80 and over business.industry Rectal Neoplasms Incidence (epidemiology) Liver Neoplasms General Medicine Safe strategy Middle Aged medicine.disease Prognosis Surgery Survival Rate medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Female Neoplasm Recurrence Local business Follow-Up Studies |
| Zdroj: | Clinicaltranslational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico. 20(8) |
| ISSN: | 1699-3055 |
| Popis: | The goal of treatment for patients with synchronous liver metastases (SLM) from rectal cancer is to achieve a complete resection of both tumor locations. For patients with symptomatic locally advanced rectal cancer with resectable SLM at diagnosis, our usual strategy has been the rectum first approach (RF). However, since 2014, we advocate for the interval approach (IS) that involves the administration of chemo-radiotherapy followed by the resection of the SLM in the interval of time between rectal cancer radiation and rectal surgery. From 2010 to 2016, 16 patients were treated according to this new strategy and 19 were treated according RF strategy. Data were collected prospectively and analyzed with an intention-to-treat perspective. Complete resection rate, duration of the treatment and morbi-mortality were the main outcomes. The complete resection rate in the IS was higher (100%, n = 16) compared to the RF (74%, n = 14, p = 0.049) and the duration of the strategy was shorter (6 vs. 9 months, respectively, p = 0.006). The incidence of severe complications after liver surgery was 14% (n = 2) in the RF and 0% in the IS (p = 1.000), and after rectal surgery was 24% (n = 4) and 12% (n = 2), respectively (p = 1.000). The IS is a feasible and safe strategy that procures higher level of complete resection rate in a shorter period of time compared to RF strategy. |
| Databáze: | OpenAIRE |
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