Hepatic vascular inflow occlusion is associated with reduced disease free survival following resection of colorectal liver metastases

2017 ◽  
Vol 43 (1) ◽  
pp. 100-106 ◽  
Author(s):  
P.B. Olthof ◽  
J. Huiskens ◽  
N.R. Schulte ◽  
D.A. Wicherts ◽  
M.G. Besselink ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Disease Free Survival ◽  
Inflow Occlusion ◽  
Free Survival ◽  
Disease Free

scholarly journals 871 Liver Transplant for Colorectal Liver Metastases: A Systematic Review and Meta-Analysis of Proportions

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
R Varley ◽  
M Tarazi ◽  
M Davé ◽  
S Mobarak ◽  
M Stott ◽  
...  
Keyword(s):  
Systematic Review ◽  
Liver Transplantation ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Palliative Chemotherapy ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Current Evidence ◽  
Free Survival ◽  
Disease Free

Abstract Introduction Colorectal liver metastases were historically considered a contraindication to liver transplantation, but dismal outcomes for those with metastatic colorectal cancer and advancements in liver transplantation (LT) have led to a renewed interest in the topic. We aim to compare the current evidence for liver transplantation for non-resectable colorectal liver metastases (NRCLM) with the current standard treatment of palliative chemotherapy reported in literature – 5-year survival rate <10%. Method A systematic review and meta-analysis of proportions was conducted following screening of MEDLINE, EMBASE, SCOPUS and CENTRAL for studies reporting liver transplantation for colorectal liver metastases. Post-operative outcomes measured included 1-, 3- and 5-year survival, overall survival, disease-free survival, and complication rates. Results Three non-randomised studies met the inclusion criteria, reporting a total of 48 patients receiving LT for NRCLM. Survival at 1-, 3- and 5-years was 83.3-100%, 58.3-80% and 50-80% respectively with no significant difference detected (p = 0.22, p = 0.48, p = 0.26). Disease free survival was 35-56% with the most common site of recurrence being lung. Thirteen out of fourteen deaths were due to disease recurrence. Conclusions Although current evidence suggests a survival benefit conferred by LT in NRCLM compared to palliative chemotherapy, the ethical implications of organ availability and allocation demand rigorous justification. Eight registered clinical trials will report on 300 more patients undergoing LT for NRCLM over the next 10 years: concomitant improvements in the management of patients following liver resection and of palliative chemotherapy regimens is paramount.

Recurrence after Complete Cryoablation of Colorectal Liver Metastases: Analysis of Prognostic Features

2006 ◽  
Vol 72 (5) ◽  
pp. 382-390
Author(s):  
Tristan D. Yan ◽  
David R. Nunn ◽  
David L. Morris
Keyword(s):  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Multivariate Analyses ◽  
Univariate Analysis ◽  
Disease Free Survival ◽  
Free Survival ◽  
Prognostic Features ◽  
Observational Cohort ◽  
Disease Free

This study critically evaluated the prognostic determinants for disease-free survival (DFS) after cryoablation for colorectal liver metastases. An observational cohort study of prospectively collected data on 135 patients who underwent cryoablation with or without resection for colorectal liver metastases was performed. Univariate and multivariate analyses were used to determine the prognostic factors for overall DFS, cryosite DFS, remaining liver DFS, and extrahepatic DFS. Overall, 115 patients (85%) developed recurrence at the cryosite (44%), and the remaining patients developed recurrence at the liver (62%) and extrahepatic site (71%). In univariate analysis, pre-operative and postoperative carcinoembryonic antigen (CEA) were significant for overall DFS. Distribution of metastases, operation type, total number of metastases, number of cryotreated metastases, largest size of cryotreated metastasis, and postoperative CEA were significant for cryosite DFS. The number of cryotreated metastases and postoperative CEA were significant for remaining liver DFS. The largest size of cryotreated metastasis, and preoperative and postoperative CEA were significant for extrahepatic DFS. In multivariate analysis, resection plus cryoablation, ≤7 liver metastases and ≤3 cm cryotreated metastasis were independently associated with an improved cryosite DFS. Preoperative CEA of ≤5 ng/mL was independently associated with an improved overall and extrahepatic DFS. The role of CEA in colorectal metastasis is important. Resection plus cryoablation rather than cryoablation alone should be used for larger lesions.

Comment on “Anatomical Resections Improve Disease-free Survival in Patients With KRAS-mutated Colorectal Liver Metastases.”

2019 ◽  
Vol 269 (4) ◽  
pp. e47-e49 ◽  
Author(s):  
Luca Viganò ◽  
Guido Costa ◽  
Christian Toso ◽  
Matteo Cimino ◽  
Axel Andres ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Disease Free Survival ◽  
Free Survival ◽  
Disease Free

Anatomical Resections Improve Disease-free Survival in Patients With KRAS-mutated Colorectal Liver Metastases

2017 ◽  
Vol 266 (4) ◽  
pp. 641-649 ◽  
Author(s):  
Georgios A. Margonis ◽  
Stefan Buettner ◽  
Nikolaos Andreatos ◽  
Kazunari Sasaki ◽  
Jan N. M. Ijzermans ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Disease Free Survival ◽  
Free Survival ◽  
Disease Free

scholarly journals Liver Transplantation for Non-Resectable Liver Metastases from Colorectal Cancer: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Rebecca Varley ◽  
Munir Tarazi ◽  
Madhav Davé ◽  
Shahd Mobarak ◽  
Martyn C. Stott ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Transplantation ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Palliative Chemotherapy ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Current Evidence ◽  
Free Survival ◽  
Disease Free

Abstract Backgrounds Colorectal liver metastases were historically considered a contraindication to liver transplantation, but dismal outcomes for those with metastatic colorectal cancer and advancements in liver transplantation (LT) have led to a renewed interest in the topic. We aim to compare the current evidence for liver transplantation for non-resectable colorectal liver metastases (NRCLM) with the current standard treatment of palliative chemotherapy. Methods A systematic review and meta-analysis of proportions was conducted following screening of MEDLINE, EMBASE, SCOPUS and CENTRAL for studies reporting liver transplantation for colorectal liver metastases. Post-operative outcomes measured included one-, three- and five-year survival, overall survival, disease-free survival and complication rate. Results Three non-randomised studies met the inclusion criteria, reporting a total of 48 patients receiving LT for NRCLM. Survival at one-, three- and five-years was 83.3–100%, 58.3–80% and 50–80%, respectively, with no significant difference detected (p = 0.22, p = 0.48, p = 0.26). Disease-free survival was 35–56% with the most common site of recurrence being lung. Thirteen out of fourteen deaths were due to disease recurrence. Conclusion Although current evidence suggests a survival benefit conferred by LT in NRCLM compared to palliative chemotherapy, the ethical implications of organ availability and allocation demand rigorous justification. Concomitant improvements in the management of patients following liver resection and of palliative chemotherapy regimens is paramount.

scholarly journals Prognostic factors for survival in patients with colorectal liver metastases: experience of a single brazilian cancer center

2012 ◽  
Vol 49 (4) ◽  
pp. 266-272 ◽  
Author(s):  
Héber Salvador de Castro Ribeiro ◽  
Paulo Roberto Stevanato-Filho ◽  
Wilson Luiz da Costa Jr. ◽  
Alessandro Landskron Diniz ◽  
Paulo Herman ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Surgical Treatment ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Disease Free Survival ◽  
Colorectal Metastases ◽  
Primary Tumors ◽  
Free Survival ◽  
Disease Free

CONTEXT: Liver metastases are a common event in the clinical outcome of patients with colorectal cancer and account for 2/3 of deaths from this disease. There is considerable controversy among the data in the literature regarding the results of surgical treatment and prognostic factors of survival, and no analysis have been done in a large cohort of patients in Brazil. OBJECTIVES: To characterize the results of surgical treatment of patients with colorectal liver metastases, and to establish prognostic factors of survival in a Brazilian population. METHOD: This was a retrospective study of patients undergoing liver resection for colorectal metastases in a tertiary cancer hospital from 1998 to 2009. We analyzed epidemiologic variables and the clinical characteristics of primary tumors, metastatic disease and its treatment, surgical procedures and follow-up, and survival results. Survival analyzes were done by the Kaplan-Meier method and the log-rank test was applied to determine the influence of variables on overall and disease-free survival. All variables associated with survival with P<0.20 in univariate analysis, were included in multivariate analysis using a Cox proportional hazard regression model. RESULTS: During the period analyzed, 209 procedures were performed on 170 patients. Postope-rative mortality in 90 days was 2.9% and 5-year overall survival was 64.9%. Its independent prognostic factors were the presence of extrahepatic disease at diagnosis of liver metastases, bilateral nodules and the occurrence of major complications after liver surgery. The estimated 5-year disease-free survival was 39.1% and its prognostic factors included R1 resection, extrahepatic disease, bilateral nodules, lymph node involvement in the primary tumor and primary tumors located in the rectum. CONCLUSION: Liver resection for colorectal metastases is safe and effective and the analysis of prognostic factors of survival in a large cohort of Brazilian patients showed similar results to those pointed in international series. The occurrence of major postoperative complications appears to be able to compromise overall survival and further investigation in needed in this topic.

scholarly journals The Prognostic Significance of Lymphatics in Colorectal Liver Metastases

HPB Surgery ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Vijayaragavan Muralidharan ◽  
Linh Nguyen ◽  
Jonathan Banting ◽  
Christopher Christophi
Keyword(s):  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Lymphatic Vessel ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Normal Liver ◽  
Vessel Density ◽  
Lymphatic Vessel Density ◽  
Free Survival ◽  
Disease Free

Background. Colorectal Cancer (CRC) is the most common form of cancer diagnosed in Australia across both genders. Approximately, 40%–60% of patients with CRC develop metastasis, the liver being the most common site. Almost 70% of CRC mortality can be attributed to the development of liver metastasis. This study examines the pattern and density of lymphatics in colorectal liver metastases (CLM) as predictors of survival following hepatic resection for CLM. Methods. Patient tissue samples were obtained from the Victorian Cancer Biobank. Immunohistochemistry was used to examine the spatial differences in blood and lymphatic vessel densities between different regions within the tumor (CLM) and surrounding host tissue. Lymphatic vessel density (LVD) was assessed as a potential prognostic marker. Results. Patients with low lymphatic vessel density in the tumor centre, tumor periphery, and adjacent normal liver demonstrated a significant disease-free survival advantage compared to patients with high lymphatic vessel density (P=0.01, P>0.01, and P=0.05, resp.). Lymphatic vessel density in the tumor centre and periphery and adjacent normal liver was an accurate predictive marker of disease-free survival (P=0.05). Conclusion. Lymphatic vessel density in CLM appears to be an accurate predictor of recurrence and disease-free survival.

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