scholarly journals The impact of somatic SMAD4 mutations in colorectal liver metastases

2019 ◽  
Vol 8 (5) ◽  
pp. 52-52 ◽  
Author(s):  
Dimitrios Xourafas ◽  
Takashi Mizuno ◽  
Jordan M. Cloyd
Keyword(s):  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
The Impact

scholarly journals Failure to Cure Colorectal Liver Metastases Patients Quantified - The Impact of the Liver Surgical Specialist

HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S129
Author(s):  
E.A. Vega ◽  
O. Salehi ◽  
O. Kocyreva ◽  
C. Conrad
Keyword(s):  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
The Impact

scholarly journals 3D Quantitative Ablation Margins for Prediction of Ablation Site Recurrence After Stereotactic Image-Guided Microwave Ablation of Colorectal Liver Metastases: A Multicenter Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Simeon J. S. Ruiter ◽  
Pascale Tinguely ◽  
Iwan Paolucci ◽  
Jennie Engstrand ◽  
Daniel Candinas ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Multicenter Study ◽  
Microwave Ablation ◽  
Colorectal Liver Metastases ◽  
Liver Tumors ◽  
Three Dimensional ◽  
Multivariable Logistic Regression Analysis ◽  
Tumor Diameter ◽  
Ablation Margin ◽  
The Impact

BackgroundThree-dimensional (3D) volumetric ablation margin assessment after thermal ablation of liver tumors using software has been described, but its predictive value on treatment efficacy when accounting for other factors known to correlate ablation site recurrence (ASR) remains unknown.PurposeTo investigate 3D quantitative ablation margins (3D-QAMs) as an algorithm to predict ASR within 1 year after stereotactic microwave ablation (SMWA) for colorectal liver metastases (CRLM).Materials and MethodsSixty-five tumors in 47 patients from a prospective multicenter study of patients undergoing SMWA for CRLM were included in this retrospective 3D-QAM analysis. Using a previously developed algorithm, 3D-QAM defined as the distribution of tumor to ablation surface distances was assessed in co-registered pre- and post-ablation CT scans. The discriminatory power and optimal cutoff values for 3D-QAM were assessed using receiver operating characteristic (ROC) curves. Multivariable logistic regression analysis using generalized estimating equations was applied to investigate the impact of various 3D-QAM outputs on 1-year ASR while accounting for other known influencing factors.ResultsTen of the 65 (15.4%) tumors included for 3D-QAM analysis developed ASR. ROC analyses identified i) 3D-QAM <1 mm for >23% of the tumor surface, ii) 3D-QAM <5 mm for >45%, and iii) the minimal ablation margin (MAM) as the 3D-QAM outputs with optimal discriminatory qualities. The multivariable regression model without 3D-QAM yielded tumor diameter and KRAS mutation as 1-year ASR predictors. When adding 3D-QAM, this factor became the main predictor of 1-year ASR [odds ratio (OR) 21.67 (CI 2.48, 165.21) if defined as >23% <1 mm; OR 0.52 (CI 0.29, 0.95) if defined as MAM].Conclusions3D-QAM allows objectifiable and standardized assessment of tumor coverage by the ablation zone after SMWA. Our data shows that 3D-QAM represents the most important factor predicting ASR within 1 year after SMWA of CRLM.

scholarly journals The impact of hepatic arterial infusion pump chemotherapy on hepatic recurrences and survival in patients with resected colorectal liver metastases

HPB ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. 1271-1279 ◽  
Author(s):  
Florian E. Buisman ◽  
Boris Galjart ◽  
Eric P. van der Stok ◽  
Nancy E. Kemeny ◽  
Vinod P. Balachandran ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Infusion Pump ◽  
Hepatic Arterial Infusion ◽  
Arterial Infusion ◽  
The Impact

Impact of preoperative chemotherapy on overall survival for borderline resectable colorectal liver metastases

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 365-365
Author(s):  
Akio Saiura ◽  
Yosuke Inoue ◽  
Yoshihiro Mise ◽  
Yu Takahashi ◽  
Takafumi Ichida ◽  
...  
Keyword(s):  
Overall Survival ◽  
Liver Resection ◽  
Liver Metastases ◽  
Preoperative Chemotherapy ◽  
Colorectal Liver Metastases ◽  
Survival Rates ◽  
Controlled Study ◽  
Free Survival ◽  
Surgical Failure ◽  
The Impact

365 Background: Treatment for borderline colorectal liver metastases (CLM) is often started with chemotherapy. However, the impact on overall survival (OS) is still unknown. Aims: The aim of this study is to analyze the impact of preoperative chemotherapy on the outcome for up-front resectable borderline CLMs (BLR-CLM). Methods: A retrospective review was performed of 169 patients who underwent liver resection of BLR-CLM among 510 patients underwent liver resection for CLM between 2005 and 2013. BLR-CRLM was defined as CRLM of four or more nodules or 5cm or larger nodule. Time to surgical failure (TSF) was defined as the time until unresectable relapse or death. OS, recurrence free survival (RFS) and TSF were compared between BLR-CLM treated with neoadjuvant chemotherapy (NAC) and up-front surgery (US). Results: After median follow-up period of 38 months, 5-year survival rate after liver resection of resectable cases (n = 263), BLR-CLM (n = 169), and initially unresectable CLM (n = 78) are 67.7%, 47.5% and 32.6%, respectively. For patients with BLR-CLM, 22 patients with early recurrence during or early after postoperative chemotherapy for the primary were excluded. In the remaining 147 patients, 75 patients were treated with NAC and 72 with US. Cumulative 5-year overall survival rates, progression free survival rates, and time-to surgical failure in NAC and US group are as follows: OS (60.1% vs 47.7%, p = 0.084), PFS (23.1% vs 15.5%, p < 0.0001), TSF (38.0% vs 34.4%, p = 0.020). Conclusions: Preoperative chemotherapy for BLR-CLM could improve PFS and TSF. The impact on OS was still marginal. Prospective controlled study will be necessary.

Hepatic Resection After Rescue Cetuximab Treatment for Colorectal Liver Metastases Previously Refractory to Conventional Systemic Therapy

2007 ◽  
Vol 25 (29) ◽  
pp. 4593-4602 ◽  
Author(s):  
René Adam ◽  
Thomas Aloia ◽  
Francis Lévi ◽  
Dennis A. Wicherts ◽  
Robbert J. de Haas ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Postoperative Mortality ◽  
Progression Free Survival ◽  
Resectability Rate ◽  
Heavily Pretreated ◽  
Unresectable Colorectal Liver Metastases ◽  
Pretreated Patients ◽  
The Impact ◽  
Cetuximab Therapy

Purpose In patients with unresectable colorectal liver metastases (CLM) resistant to first-line chemotherapy, the impact of cetuximab therapy on resectability is unknown. This study was performed to determine the post-cetuximab resectability rate and to examine postoperative outcomes for these heavily pretreated patients. Patients and Methods From February 2004 to April 2006, we evaluated 151 patients with unresectable CLM resistant to initial chemotherapy and subsequently treated with systemic cetuximab. Resectability rates, patient outcomes, and tumoral and nontumoral liver pathology were assessed. Results A total of 27 patients underwent surgery after a median of six cycles of cetuximab + irinotecan (20 of 27), oxaliplatin (four of 27), or both (one of 27). Eighteen patients (67%) had experienced treatment failure after at least two lines of chemotherapy before cetuximab. Twenty-five of the 27 patients who had surgery underwent hepatectomy: nine of 133 patients who were treated completely at our institution (resectability rate, 7%) and 16 of 18 patients who were referred from other institutions after systemic cetuximab therapy. Postoperative mortality was 3.7% (one of 27), with a complication rate of 50%. Histopathologic liver abnormalities were found in nine patients (36%), without specific lesions attributable to cetuximab. After median follow-up of 16 months, 23 of 25 patients who underwent resection (92%) were alive, and 10 patients (40%) were disease free. Median overall (OS) and progression-free survival (PFS) from initiation of cetuximab therapy were 20 and 13 months, respectively. Conclusion For CLM refractory to conventional chemotherapy, combination therapy with cetuximab increases resectability rates without increasing operative mortality or liver injury. The median OS and PFS of 20 and 13 months, respectively, suggest that this novel oncosurgical strategy benefits patients with previously refractory disease who respond subsequently to cetuximab.

scholarly journals Multidisciplinary Treatment for Colorectal Liver Metastases in Elderly Patients

2020 ◽  
Author(s):  
Taigo Hata ◽  
Yoshihiro Mise ◽  
Yoshihiro Ono ◽  
Takafumi Sato ◽  
Yosuke Inoue ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Multidisciplinary Treatment ◽  
Age Groups ◽  
Age Group ◽  
Liver Recurrence ◽  
Initial Hepatectomy ◽  
The Impact ◽  
Disease Specific

Abstract Background: Limited data describe the therapeutic practice and outcomes of colorectal liver metastases (CRLMs) in elderly patients. We aimed to evaluate the impact of age on multidisciplinary treatment for CRLMs. Methods: We reviewed treatment and outcomes for patients in different age groups who underwent initial hepatectomy for CRLMs from 2004 through 2012.Results: We studied 462 patients who were divided into three groups by age: ≤ 64 years (n = 265), 65–74 years (n = 151), and ≥ 75 years (n = 46). The rate of major hepatectomy and incidence of postoperative complications did not differ between groups. Adjuvant chemotherapy was used less in the ≥ 75 -year group (19.6%) than that in the ≤ 64 (54.3%) or 65–74 age group (43.5%). Repeat hepatectomy for liver recurrence was performed less in the ≥ 75 -year group (35%) than in the ≤ 64 (57%) or 65–74 (66%) age group. The 5-year disease-specific survival (DSS) rate of 44.2% in the ≥ 75 -year group was lower than in the ≤ 64 (59.0%) or 65–74 (64.7%) age group. Multivariate analysis revealed age ≥ 75 years was an independent predictor of poor DSS.Conclusions: Liver resection for CRLMs can be performed safely in elderly patients. However, repeat resection for recurrence are performed less frequently in the elderly, which may lead to the poorer disease-specific prognosis.

The impact of open colectomy on resection of colorectal liver metastases.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 783-783
Author(s):  
Stuart Michael Robinson ◽  
Lucas Arlott ◽  
Gourab Sen ◽  
Jeremy J. French ◽  
Richard M. Charnley ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Survival Data ◽  
Colorectal Liver Metastases ◽  
Primary Tumour ◽  
Open Colectomy ◽  
Surgical Morbidity ◽  
Conversion To Open Surgery ◽  
Duration Of Surgery ◽  
The Impact

783 Background: Laparoscopic liver resection (LLR) is increasingly utilized in the management of patients with metastatic colorectal cancer. The aim of this study was to determine the impact of open vs. colonic resection of the primary tumour on outcomes following LLR. Methods: A prospectively maintained database was searched to identify all patients undergoing laparoscopic resection for colorectal liver metastases (CRLM) between 1/1/2007 and 31/12/2013. Demographic, histological, surgical outcome and survival data were collated retrospectively. Statistical analysis was performed using SPSS. Results: A total of 71 patients (median age 66 yr; 64% male) underwent resection in this study of whom 35 had a laparoscopic colectomy (LC). The presence of a previous open colectomy (OC) surgical morbidity (17% vs. 11%; p=0.53); conversion to open surgery (22% both groups; p=0.95); duration of surgery (240 min vs. 285 min; p=0.28); or length of hospital stay (5 vs. 6 days; p=0.98). Overall survival in this series was 47 months with no difference between groups (p=0.58). Patients who underwent OC appeared to have a poorer recurrence free survival (8 vs. 21 months; p=0.03) although on multivariate analysis the only factor predictive of early recurrence was a node positive primary (OR 3.8; p=0.05). Conclusions: In patients being considered for LLR for metastasic colorectal cancer the surgical approach to colectomy has no bearing on either short term surgical outcomes or longer term disease specific survival.

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