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Kazunari Sasaki, Daisuke Morioka, Simone Conci, Georgios A Margonis, Yu Sawada, Andrea Ruzzenente, Takafumi Kumamoto, Calogero Iacono, Nikolaos Andreatos, Alfredo Guglielmi, Itaru Endo, Timothy M Pawlik
OBJECTIVE: To apply the principles of the Metro-ticket paradigm to develop a prognostic model for patients undergoing hepatic resection of colorectal liver metastasis (CRLM). BACKGROUND: Whereas the hepatocellular "Metro-ticket" prognostic tool utilizes a continuum of tumor size and number, a similar concept of a CRLM Metro-ticket paradigm has not been investigated. METHODS: Tumor Burden Score (TBS) was defined using distance from the origin on a Cartesian plane incorporating maximum tumor size (x-axis) and number of lesions (y-axis)...
October 19, 2016: Annals of Surgery
Ernesto Sparrelid, Stefan Gilg, Torkel B Brismar, Lars Lundell, Bengt Isaksson
PURPOSE: The aim of this study was to investigate whether associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) can be used as an effective and safe rescue procedure in patients with colorectal liver metastases (CRLM) and insufficient effect on the future liver remnant (FLR) after previous portal vein occlusion (PVO). METHODS: Eleven patients with bilobar CRLM treated with neoadjuvant chemotherapy and previous PVO with insufficient effect on the FLR were analyzed retrospectively from a prospective database...
October 19, 2016: Langenbeck's Archives of Surgery
Luca Portigliotti, David Fuks, Oleg Slivca, Christophe Bourdeaux, Takeo Nomi, Mostefa Bennamoun, Sergio Gentilli, Brice Gayet
INTRODUCTION: The benefit of by laparoscopic resection for lesions located in postero-superior segments is unclear. The present series aimed at comparing intraoperative and post-operative results in patients undergoing either laparoscopic RPS or laparoscopic RH for colorectal liver metastases located in the right postero-superior segments. METHODS: From 2000 to 2015, patients who underwent laparoscopic resection of segment 6 and/or 7 (RPS group) were compared with those with right hepatectomy (RH group) in terms of tumour characteristics, surgical treatment, and short-term outcomes...
October 17, 2016: Surgical Endoscopy
Satoshi Nagayama, Suguru Hasegawa, Koya Hida, Kenji Kawada, Etsuro Hatano, Kojiro Nakamura, Satoru Seo, Kojiro Taura, Kentaro Yasuchika, Takashi Matsuo, Masazumi Zaima, Akiyoshi Kanazawa, Hiroaki Terajima, Masaharu Tada, Yukihito Adachi, Ryuta Nishitai, Dai Manaka, Tsunehiro Yoshimura, Koji Doi, Takahiro Horimatsu, Akira Mitsuyoshi, Kenichi Yoshimura, Miyuki Niimi, Shigemi Matsumoto, Yoshiharu Sakai, Shinji Uemoto
BACKGROUND: Although liver resection combined with preoperative chemotherapy is expected to improve outcomes of patients with resectable colorectal liver metastasis (CRLM), there is as yet insufficient clinical evidence supporting the efficacy of preoperative systemic chemotherapy. The aim of this phase II study was to assess the feasibility and efficacy of preoperative FOLFOX systemic chemotherapy for patients with initially resectable CRLM. METHODS: A prospective multi-institutional phase II study was conducted to evaluate the feasibility and efficacy of preoperative chemotherapy for resectable CRLM (ClinicalTrials...
October 17, 2016: International Journal of Clinical Oncology
Santiago Marfà, Josep Marti, Adalgiza Reyes, Gregori Casals, Guillermo Fernández-Varo, Silvia Carvajal, J C García-Valdecasas, Josep Fuster, Wladimiro Jiménez
Colorectal cancer (CRC) is one of the most common cancers in the developed countries, and nearly 70% of patients with CRC develop colorectal liver metastases (CRLMs). During the last decades, several scores have been proposed to predict recurrence after CRLM resection. However, these risk scoring systems do not accurately reflect the prognosis of these patients. Therefore, this investigation was designed to identify a proteomic profile in human hepatic tumor samples to classify patients with CRLM as "mild" or "severe" based on the 5-year survival...
October 2016: Translational Oncology
Axel Andres, Pietro Majno, Sylvain Terraz, Philippe Morel, Arnaud Roth, Laura Rubbia-Brandt, Eduardo Schiffer, Frederic Ris, Christian Toso
Colorectal liver metastasis (CRLM) is the most frequent indication for liver resection in many centers. Recent improvements in oncology, surgery, interventional radiology, pathology and anesthesiology allow curative treatment in a larger proportion of patients with CRLM. Areas covered: We illustrate the various aspects of the management of CRLM through 11 questions that summarize the topic, from the current obtained survival to future perspectives such as transplantation. The limits of a curative treatment are also presented from different angles, such as the benefits of pathology, the surgical options for extreme resections, the available chemotherapies and their efficacy, or the non-surgical ablative treatments...
October 17, 2016: Expert Review of Anticancer Therapy
Masakazu Hashimoto, Tsuyoshi Kobayashi, Kohei Ishiyama, Kentaro Ide, Masahiro Ohira, Hiroyuki Tahara, Shintaro Kuroda, Michinori Hamaoka, Hiroshi Iwako, Masashi Okimoto, Hideki Ohdan
BACKGROUND: Despite improvements in surgery and chemotherapy, most patients develop recurrence after initial hepatectomy for colorectal liver metastasis (CRLM). Following initial hepatectomy for CRLM, patterns and surgical management of recurrence have not been widely reported. MATERIALS AND METHODS: We identified 128 patients who underwent hepatic resection for CRLM between January 2000 and December 2012. Demographics, operative data, site of recurrence, and long-term survival data were collected and analyzed...
October 11, 2016: International Journal of Surgery
Sulaiman Nanji, Melanie E Tsang, Xuejiao Wei, Christopher M Booth
BACKGROUND: More than half of the patients undergoing resection for colorectal cancer liver metastases develop recurrent hepatic disease. We report management and outcomes of patients undergoing repeat hepatectomy in routine practice. METHODS: All cases of repeat hepatectomy for colorectal cancer liver metastases from 2002 to 2009 in the Canadian Province of Ontario were identified using the population-based Ontario Cancer Registry and linked treatment records. RESULTS: Of 1,310 patients who underwent resection of CRLM, 78 (6...
September 6, 2016: American Journal of Surgery
Anne Helene Køstner, Christian Kersten, Thyra Löwenmark, Karin A Ydsten, Reetta Peltonen, Helena Isoniemi, Caj Haglund, Ulf Gunnarsson, Bengt Isaksson
BACKGROUND AND OBJECTIVES: Systemic inflammation has been associated with poor survival in several tumor types, but has been less extensively studied in resectable metastatic disease. The aim of the present study was to evaluate the prognostic role of CRP in colorectal cancer patients with liver metastases (CRLM) compared to conventional tumor- and patient-related clinicopathological features as well as other indicators of the systemic inflammatory response (SIR). METHODS: A multinational retrospective study of 492 CRLM patients undergoing potentially curative resection of liver metastases between 1999 and 2009...
October 3, 2016: Journal of Surgical Oncology
E P van der Stok, M Smid, A M Sieuwerts, P B Vermeulen, S Sleijfer, N Ayez, D J Grünhagen, J W M Martens, C Verhoef
BACKGROUND: Identification of specific risk groups for recurrence after surgery for isolated colorectal liver metastases (CRLM) remains challenging due to the heterogeneity of the disease. Classical clinicopathologic parameters have limited prognostic value. The aim of this study was to identify a gene expression signature measured in CRLM discriminating early from late recurrence after partial hepatectomy. METHODS: CRLM from two patient groups were collected: I) with recurrent disease ≤12 months after surgery (N = 33), and II) without recurrences and disease free for ≥36 months (N = 30)...
September 20, 2016: Molecular Oncology
P B Olthof, J Huiskens, N R Schulte, D A Wicherts, M G Besselink, O R C Busch, P J Tanis, T M van Gulik
BACKGROUND: Hepatic vascular inflow occlusion (VIO) can be applied during resection of colorectal liver metastases (CRLM) to control intra-operative blood loss, but has been linked to accelerated growth of micrometastases in experimental models. This study aimed to investigate the effects of hepatic VIO on disease-free and overall survival (DFS and OS) in patients following resection for CRLM. METHODS: All patients who underwent liver resection for CRLM between January 2006 and September 2015 at our center were analyzed...
September 17, 2016: European Journal of Surgical Oncology
Daisuke Hokuto, Takeo Nomi, Ichiro Yamato, Satoshi Yasuda, Shinsaku Obara, Takahiro Yoshikawa, Chihiro Kawaguchi, Takatsugu Yamada, Hiromichi Kanehiro, Yoshiyuki Nakajima
BACKGROUND AND OBJECTIVES: The impact of perioperative chemotherapy on patients with multiple colorectal liver metastases (CRLM) remains unclear. We attempted to examine whether the introduction of modern chemotherapies has improved the prognosis of patients that undergo liver resection for ≥4 CRLM. METHODS: Between January 1990 and December 2013, 194 patients underwent liver resection for CRLM at our institution. The outcomes of the patients with ≥4 and 1-3 CRLM were compared before and after 2005, when modern chemotherapies were introduced to Japan...
September 28, 2016: Journal of Surgical Oncology
Georgios Antonios Margonis, Neda Amini, Kazunari Sasaki, Yuhree Kim, Katiuscha Merath, Stefan Buettner, Emmanouil Pikoulis, Nikolaos Andreatos, Doris Wagner, Efstathios Antoniou, Timothy M Pawlik
INTRODUCTION: There is limited evidence characterizing the impact of glycemic alterations on short-term outcomes among patients undergoing resection of colorectal liver metastases (CRLM). METHODS: Hyperglycemia was defined as a glucose value >125 mg/dl according to WHO definition. The impact of early postoperative hyperglycemia on short-term postoperative outcomes was assessed. RESULTS: The mean postoperative glucose value was 128 mg/dl; 30 (9...
September 27, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Emmanouil Pikoulis, Georgios A Margonis, Nikolaos Andreatos, Kazunari Sasaki, Anastasios Angelou, Georgios Polychronidis, Anastasia Pikouli, Elena Riza, Timothy M Pawlik, Efstathios Antoniou
BACKGROUND/AIMS: The impact of tumor biology on prognosis in patients with colorectal liver metastasis (CRLM) has been the topic of intense research. Specifically, the presence of BRAF mutations has been recently associated with adverse long-term outcomes. We examined the existing literature on the prognostic implications of BRAF mutations in patients with CRLM. MATERIALS AND METHODS: A structured review of the literature was performed between 5/1/2016 and 6/1/2016 using the PubMed database...
September 2016: Anticancer Research
M Okuno, E Hatano, H Nishino, S Seo, K Taura, S Uemoto
PURPOSE: This study aimed to evaluate whether the response rate of chemotherapy with molecular target agents correlates with the conversion rate, R0 resection rate, and survival in patients with initially unresectable colorectal liver metastases (CRLM). METHODS: We reviewed the literature of prospective, controlled trials of systemic chemotherapy for patients with unresectable liver-only CRLM, including resectable extrahepatic metastases. Pearson's correlation coefficients were calculated...
August 31, 2016: European Journal of Surgical Oncology
Rohan Kumar, Ashley R Dennison, Vaux Robertson, Michael J Jones, Christopher P Neal, Giuseppe Garcea
BACKGROUND: Clinical risk scores (CRS) within the context of neoadjuvant chemotherapy for colorectal liver metastases (CRLM) has not been validated. The predictive value of clinical risk scoring in patients administered neoadjuvant chemotherapy prior to liver surgery for CRLM is evaluated. METHODS: A prospective database over a 15-year period (April 1999 to March 2014) was analysed. We identified two groups: A, neoadjuvant chemotherapy prior to CRLM surgery; and B, no neoadjuvant chemotherapy...
September 12, 2016: ANZ Journal of Surgery
Ali Ahmad, Jeffrey Reha, Ponnandai Somasundar, N Joseph Espat, Steven C Katz
BACKGROUND: Surgical resection is the only curative option for patients with colorectal liver metastases (CRLM). The objective of our study was to identify factors associated with failure to refer patients with CRLM to a surgeon with oncologic and hepatobiliary expertise. MATERIALS AND METHODS: Data were retrospectively reviewed on 75 patients with CRLM treated at our institution. Patients were divided into referred and nonreferred groups for comparison. Quantitative assessment of association was tabulated using the odds ratio (OR)...
September 2016: Journal of Surgical Research
Erik Tanis, Danny J Evers, Jarich W Spliethoff, Vishnu V Pully, Koert Kuhlmann, Frits van Coevorden, Benno H W Hendriks, Joyce Sanders, Warner Prevoo, Theo J M Ruers
BACKGROUND AND OBJECTIVE: Over the last decade, an increasing effort has been put towards the implementation of optical guidance techniques to aid surgeons during cancer surgery. Diffuse reflectance spectroscopy (DRS) and fluorescence spectroscopy (FS) are two of these new techniques. The objective of this study is to investigate whether in vivo optical spectroscopy is able to accurately discriminate colorectal liver metastases (CRLM) from normal liver tissue in vivo. MATERIALS AND METHODS: DRS and FS were incorporated at the tip of a needle and were used for in vivo tissue differentiation during resection of CRLM...
September 8, 2016: Lasers in Surgery and Medicine
Haowen Tang, Bingmin Li, Haoyun Zhang, Jiahong Dong, Wenping Lu
It remains unclear whether hepatectomy for colorectal liver metastasis (CRLM) should be performed as anatomical resection (AR) or nonanatomical resection (NAR). The aim of this study is to compare the short- and long-term outcomes of AR and NAR for CRLM. PubMed, Web of Science, EMBASE and the Cochrane Library were systematically searched to identify eligible studies. Twenty one studies involving 5207 patients were analyzed: 3034 (58.3%) underwent AR procedure and 2173 (41.7%) underwent NAR procedure. The results showed that overall survival (OS, hazard ratio (HR) 1...
2016: Scientific Reports
Julie Hallet, Antonio Sa Cunha, Rene Adam, Diane Goéré, Daniel Azoulay, Jean-Yves Mabrut, Fabrice Muscari, Christophe Laurent, Francis Navarro, Patrick Pessaux
BACKGROUND: Recurrence remains frequent after curative-intent hepatectomy for colorectal liver metastases (CRLM). We sought to define short- and long-term outcomes, and identify prehepatectomy factors associated with survival, following rehepatectomy (RH) for recurrence. METHODS: We conducted a multi-institutional cohort study of hepatectomy for CRLM over 2006-2013. Second-stage resections were excluded. Primary outcomes were overall survival (OS) and recurrence-free survival (RFS) assessed using Kaplan-Meier methods...
August 29, 2016: Annals of Surgical Oncology
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