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Mechteld C de Jong, Rianne C J Beckers, Victor van Woerden, Julie M L Sijmons, Marc H A Bemelmans, Ronald M van Dam, Cornelis H C Dejong
BACKGROUND: The feasibility of the liver-first approach for synchronous colorectal liver metastases (CRLM) has been established. We sought to assess the short-term and long-term outcomes for these patients. METHODS: Outcomes of patients who underwent a liver-first approach for CRLM between 2005 and 2015 were retrospectively evaluated from a prospective database. RESULTS: Of the 92 patients planned to undergo the liver-first strategy, the paradigm could be completed in 76...
February 15, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Andrea Tufo, Declan F J Dunne, Nichola Manu, Heman Joshi, Carmen Lacasia, Louise Jones, Hassan Z Malik, Graeme J Poston, Stephen W Fenwick
BACKGROUND: Concern exists regarding the use of hepatectomy to treat colorectal liver metastasis (CRLM) in octogenarians due to prior studies suggesting elevated morbidity and mortality. Cardiopulmonary exercise testing (CPET) within pre-operative assessment and enhanced recovery after surgery (ERAS) have both been shown to be associated with low morbidity and mortality in patients undergoing hepatectomy. This study sought to compare the outcomes of octogenarians with patients aged 70-79 undergoing hepatectomy for CRLM, within a center utilizing both CPET and ERAS...
February 6, 2018: European Journal of Surgical Oncology
Bart A W Jacobs, Nikol Snoeren, Morsal Samim, Hilde Rosing, Niels de Vries, Maarten J Deenen, Jos H Beijnen, Jan H M Schellens, Miriam Koopman, Richard van Hillegersberg
PURPOSE: The dihydrouracil (DHU):uracil (U) plasma ratio is a promising marker for identification of dihydropyrimidine dehydrogenase (DPD)-deficient patients. The objective of this study was to determine the effect of liver resection on the DHU:U plasma ratio in patients with colorectal liver metastases (CRLM). METHODS: An observational study was performed in which DHU:U plasma ratios in patients with CRLM were analyzed prior to and 1 day after liver resection...
February 11, 2018: European Journal of Clinical Pharmacology
Fabien Le Roux, Lionel Rebibo, Cyril Cosse, Denis Chatelain, Eric Nguyen-Khac, Rachid Badaoui, Jean-Marc Regimbeau
INTRODUCTION: Liver resection in cirrhotic patients is associated with increased morbidity and mortality. The objective of this study was to compare short-term results of laparoscopic resection (LR) and open surgery (OS) for minor liver resection in patients with hepatocellular carcinoma (HCC) hepatocellularcarcinoma on nontumor cirrhotic liver (HCC/F4) and patients with colorectal cancer liver metastases (CRLMs) colorectal liver metastases on healthy liver (CRLM/F0). MATERIALS AND METHODS: Between January 2005 and December 2014, all patients undergoing liver resection (n = 754) were included in this study...
January 19, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Fiona Hand, Rebeca Sanabria Mateos, Michael Durand, David Fennelly, Ray McDermott, Donal Maguire, Justin Geoghegan, Des Winter, Emir Hoti
Local invasion of adjacent viscera by colorectal liver metastases (CRLM) is no longer considered an absolute contraindication to curative hepatic resection. A growing number of observational analyses have illustrated the feasibility of such resections; however, the evidence base is at best heterogeneous with a lack of evidence comparing similar patient groups. We aimed to evaluate the outcomes of hepatectomy for CRLM when combined with other viscera and compare to a matched cohort of isolated hepatic resections...
January 18, 2018: Digestive Surgery
Takayuki Kawai, Claire Goumard, Florence Jeune, Eric Savier, Jean-Christophe Vaillant, Olivier Scatton
BACKGROUND: Although adjuvant chemotherapy (AC) is widely used after liver resection (LR) for colorectal liver metastasis (CRLM), surgical invasiveness may lead to delay in starting AC, which is preferably started within 8 weeks postoperative. We investigated whether laparoscopic liver resection (LLR) for CRLM facilitates AC start without delay. METHODS: Between November 2014 and December 2016, 117 consecutive CRLM patients underwent LR followed by AC. LLR and OLR were performed in 30 and 87 patients, respectively...
January 16, 2018: Surgical Endoscopy
William Torén, Daniel Ansari, Bodil Andersson, Lidewij Spelt, Roland Andersson
AIM: To investigate the role of thymidylate synthase (TS) as a predictive biomarker in patients with resected colorectal liver metastases (CRLM). MATERIALS & METHODS: PubMed, EMBASE and Cochrane Library were queried up to June 2017. Meta-analysis was performed using random-effects model. Risk of bias was assessed using funnel plots. RESULTS: Six eligible studies were included, comprising a total of 542 patients. Meta-analysis demonstrated a trend to reduced overall survival in patients with resected CRLM with TS overexpression, with a hazard ratio of 1...
January 10, 2018: Future Oncology
Jennifer M J Jongen, Charlotte E N M Rosenbaum, Manon N G J A Braat, Maurice A A J van den Bosch, Daniel Y Sze, Onno Kranenburg, Inne H M Borel Rinkes, Marnix G E H Lam, Andor F van den Hoven
PURPOSE: To assess applicability of metabolic tumor response assessment on 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) after radioembolization (RE) in patients with colorectal liver metastases (CRLM) by comparison with one-dimensional size-based response assessment on MR imaging. MATERIALS AND METHODS: This prospective cohort study comprised 38 patients with CRLM undergoing RE. MR imaging and 18F-FDG PET/CT imaging were performed at baseline, 1 month (n = 38), and 3 months (n = 21)...
December 14, 2017: Journal of Vascular and Interventional Radiology: JVIR
Yousun Ko, Jihang Kim, Joseph Kyu-Hyung Park, Haeryoung Kim, Jai Young Cho, Sung-Bum Kang, Soyeon Ahn, Kyong Joon Lee, Kyoung Ho Lee
OBJECTIVE: To retrospectively determine the sensitivity of preoperative CT in the detection of small (≤ 10 mm) colorectal liver metastasis (CRLM) nodules in patients undergoing liver resection. METHODS: The institutional review board approved the study and waived informed consent. We included 461 pathologically confirmed CRLM nodules in 211 patients (including 71 women; mean age, 66.4 years) who underwent 229 liver resections following abdominal CT. Prior to 163 resections, gadoxetic acid-enhanced liver MR imaging was also performed...
2017: PloS One
Rui Mao, Jian-Jun Zhao, Xin-Yu Bi, Ye-Fan Zhang, Zhi-Yu Li, Jian-Guo Zhou, Hong Zhao, Jian-Qiang Cai
PURPOSE: We sought to determine the impact of surgical margin status on overall survival (OS) and recurrence pattern stratified by tumor burden. MATERIALS AND METHODS: Data were collected from patients undergoing resection for colorectal liver metastases (CRLM). Tumor burden was calculated according to a newly proposed Tumor Burden Score (TBS) system, defined as the distance from the origin on a Cartesian plane that incorporated maximum tumor size and number of liver lesions...
December 8, 2017: International Journal of Surgery
Rianne C J Beckers, Doenja M J Lambregts, Max J Lahaye, Sheng-Xiang Rao, Kelly Kleinen, Cecile Grootscholten, Geerard L Beets, Regina G H Beets-Tan, Monique Maas
BACKGROUND: The assessment of colorectal liver metastases (CRLM) after treatment with chemotherapy is challenging due to morphological and/or functional change without changes in size. The aim of this review was to assess the value of FDG-PET, FDG-PET-CT, CT and MRI in predicting response to chemotherapy in CRLM. METHODS: A systematic review was undertaken based on PRISMA statement. PubMed and Embase were searched up to October 2016 for studies on the accuracy of PET, PET-CT, CT and MRI in predicting RECIST or metabolic response to chemotherapy and/or survival in patients with CRLM...
November 28, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Georgios A Margonis, Theodoros N Sergentanis, Ioannis Ntanasis-Stathopoulos, Nikolaos Andreatos, Ioannis-Georgios Tzanninis, Kazunari Sasaki, Theodora Psaltopoulou, Jaeyun Wang, Stefan Buettner, Αpostolos E Papalois, Jin He, Christopher L Wolfgang, Timothy M Pawlik, Matthew J Weiss
OBJECTIVE: To examine the impact of surgical margin width on survival following R0 hepatic resection for colorectal metastases (CRLM). SUMMARY OF BACKGROUND DATA: Although negative resection margin is considered of paramount importance for the prognosis of patients with colorectal liver metastases, optimal resection margin width remains controversial. METHODS: Eligible studies examining the association between margin status after R0 hepatic resection for CRLM and survival, including overall survival (OS) and disease-free survival (DFS) were sought using the Medline, Cochrane, and EMBASE databases...
November 16, 2017: Annals of Surgery
John M Creasy, Eran Sadot, Bas Groot Koerkamp, Joanne F Chou, Mithat Gonen, Nancy E Kemeny, Leonard B Saltz, Vinod P Balachandran, T Peter Kingham, Ronald P DeMatteo, Peter J Allen, William R Jarnagin, Michael I D'Angelica
BACKGROUND: The impact of primary tumor location on overall survival (OS), recurrence-free survival (RFS), and long-term outcomes has not been well established in patients undergoing potentially curative resection of colorectal liver metastases (CRLM). METHODS: A single-institution database was queried for initial resections for CRLM 1992-2004. Primary tumor location determined by chart review (right = cecum to transverse; left = splenic flexure to sigmoid)...
November 27, 2017: Annals of Surgical Oncology
Yusheng Cheng, Lei Zhang, Huizi Li, Li Wang, Yiming Huang, Lihao Wu, Yingcai Zhang
BACKGROUND: Laparoscopic liver resection (LLR) has been proposed as a safe and feasible treatment option for colorectal liver metastasis (CRLM). However, the short-term and oncologic outcomes of LLR versus open liver resection (OLR) for CRLM have not been adequately assessed. Thus, we herein provide an updated systematic review comparing short-term and oncologic outcomes of CRLM patients undergoing LLR versus OLR. METHODS: A systematic literature search was performed in the Pubmed, Embase, and Cochrane Library databases (until November 2, 2016) with a limitation to the publications in English...
December 2017: Journal of Surgical Research
Meidai Kasai, Nancy Van Damme, Giammauro Berardi, Karen Geboes, Stéphanie Laurent, Roberto I Troisi
BACKGROUND: This study evaluates the surgical stress response following laparoscopic and open liver resection for colorectal liver metastasis (CRLM). METHODS: Patients with CRLM were prospectively randomized to receive open or laparoscopic liver resection (NCT03131778). Blood samples were drawn preoperatively and 24 h after resection. The serum interleukin-6 (IL-6) and IL-8 levels were measured. Furthermore, the mRNA levels of angiogenesis-related factors (vascular endothelial growth factor [VEGF] and HIF-1) and inflammation-related factors (COX-2 and MMP-9) in both tumor tissue and normal liver parenchyma were detected...
November 27, 2017: Acta Chirurgica Belgica
D Heise, W Bayings, A Tuinhof, R Eickhoff, A Kroh, F Ulmer, C H C Dejong, U Neumann, M Binnebösel
BACKGROUND: Repeat hepatectomy is a widely accepted treatment for patients with recurrent colorectal liver metastasis (CRLM). The aim of this study was to compare initial and repeat hepatic resection concerning overall survival, prognostic factors and postoperative quality of life. METHODS: Data on patients who underwent initial or repeat hepatic resection for CRLM between 2010 and 2016 were prospectively collected and retrospectively evaluated. Follow-up data, EORTC QLQ-C30 and QLQ-LMC21 questionnaire results for quality of life (QoL) evaluation were analyzed...
November 23, 2017: International Journal of Surgery
Linda M Pak, Nancy E Kemeny, Marinela Capanu, Joanne F Chou, Taryn Boucher, Andrea Cercek, Vinod P Balachandran, T Peter Kingham, Peter J Allen, Ronald P DeMatteo, William R Jarnagin, Michael I D'Angelica
BACKGROUND/OBJECTIVES: Combination hepatic artery infusion (HAI) and systemic (SYS) chemotherapy for unresectable CRLM results in high tumor-response rates. This study represents an update of long-term survival and conversion to resectability in patients with unresectable CRLM treated with HAI and SYS chemotherapy in a phase II study. METHOD: The primary endpoint was complete resection. Multivariate and landmark analysis assessed the effect of complete resection on progression-free (PFS) and overall survival (OS)...
November 22, 2017: Journal of Surgical Oncology
Xiaoming Yang
Image-guided percutaneous thermal ablation has been one of the principal tools in management of unresectable liver malignancies, including colorectal liver metastases (CRLM) ( 1 ). Currently, however, this technique is suitable mainly for tumors less than 4-5 cm in diameter and also results in incomplete ablation at tumor margins ( 2 ). To solve these problems, efforts have been made to combine thermal ablation with other treatment options, such as systemic and intra-arterial administration of therapeutics ( 3 - 5 )...
December 2017: Radiology
Joost Huiskens, Pim B Olthof, Eric P van der Stok, Thomas Bais, Krijn P van Lienden, Adriaan Moelker, Jan Krumeich, Rudi M Roumen, Dirk J Grünhagen, Cornelis J A Punt, Martin van Amerongen, Johannes H W de Wilt, Cornelis Verhoef, Thomas M Van Gulik
INTRODUCTION: There is an ongoing controversy surrounding portal vein embolization (PVE) regarding the short-term safety of PVE and long-term oncological benefit. This study aims to compare survival outcomes of patients subjected to major liver resection for colorectal liver metastases (CRLM) with or without PVE. METHODS: All consecutive patients who underwent major liver resection for CRLM in four high volume liver centres between January 2000 and December 2015 were included...
September 20, 2017: European Journal of Surgical Oncology
Kun Wang, Wei Liu, Xiao-Luan Yan, Juan Li, Bao-Cai Xing
Numerous factors affect the prognosis of colorectal liver metastasis (CRLM) patients after hepatic resection. We investigated several factors related to overall survival in patients with CRLM to identify those most likely to benefit from hepatic resection, and produced a rational tumor biology score system. Three hundred CRLM patients treated with preoperative chemotherapy followed by hepatic resection between 2006 and 2016 were enrolled in our study. Clinicopathologic and long-term survival data were collected and assessed...
October 3, 2017: Oncotarget
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