Bilobar spreading of colorectal liver metastases does not significantly affect survival after R0 resection in the era of interdisciplinary multimodal treatmentReportar como inadecuado




Bilobar spreading of colorectal liver metastases does not significantly affect survival after R0 resection in the era of interdisciplinary multimodal treatment - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

International Journal of Colorectal Disease

, Volume 27, Issue 10, pp 1359–1367

First Online: 21 March 2012Accepted: 02 March 2012

Abstract

PurposeBilobar colorectal liver metastases CRLM are often considered incurable or associated with poor prognosis even after R0 resection. In this single-center study, we evaluate the impact of CRLM spreading on recurrence-free survival RFS and cancer-specific overall survival CSS after R0 resection of CRLM with respect to multimodal treatment strategies including perioperative chemotherapy and multistep resections.

MethodsBetween January 2001 and December 2010, R0 resection could be achieved in 70 patients with bilobar and 100 with unilobar CRLM. Extent of disease, perioperative chemotherapy, surgical procedures, adjuvant treatment, histopathological workup, RFS, and CSS were compared between both cohorts.

ResultsForty-six 66 % patients with bilobar and 26 26 % patients with unilobar CRLM received preoperative chemotherapy p < 0.001. For bilobar CRLM, more extended and multistep resection including portal vein occlusion were performed 29 % versus 3 %; p < 0.001. Morbidity 39 % versus 28 %, p = 0.183 and mortality 1 % versus 3 %, p = 0.644 rates were comparable in both patients’ cohorts. Postoperative therapy was applied in adjuvant intent to 42 60 % versus 51 51 % patients p = 0.275. The 5-year RFS and CSS rates were 24 % versus 31 % p = 0.169 and 42 % versus 55 % p = 0.131, respectively.

ConclusionsTo our single-center experience, there is no significant effect of CRLM spreading bilobar versus unilobar on RFS and CSS rates. Bilobar CRLM are more likely to require extended multimodal efforts to achieve R0 resection.

KeywordsBilobar colorectal liver metastases Liver resection Multimodal treatment Two-stage resection Electronic supplementary materialThe online version of this article doi:10.1007-s00384-012-1455-1 contains supplementary material, which is available to authorized users.

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Autor: K. Homayounfar - A. Bleckmann - L. C. Conradi - T. Sprenger - T. Beissbarth - T. Lorf - M. Niessner - C. O. Sahlmann - J

Fuente: https://link.springer.com/article/10.1007/s00384-012-1455-1







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