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Stage IV colorectal cancer: Outcomes following the liver‐first approach
Author(s) -
de Rosa Antonella,
Gomez Dhanwant,
Hossaini Sina,
Duke Katie,
Fenwick Stephen W.,
Brooks Adam,
Poston Graema J.,
Malik Hassan Z.,
Cameron Iain C.
Publication year - 2013
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23429
Subject(s) - medicine , colorectal cancer , tertiary referral centre , referral , stage (stratigraphy) , demographics , chemotherapy , pathological , cancer , surgery , paleontology , demography , family medicine , sociology , biology
Background To date, there is limited data on the liver‐first approach in the management of colorectal liver metastases (CRLM). The aim of the study was to assess the outcomes of the liver‐first approach for patients with synchronous CRLM in two tertiary referral centers. Methods Patients with stage IV colorectal cancer selected for the liver‐first approach from January 2009 to December 2012 in two tertiary referral centers were included. Data collated included demographics, chemotherapy, operative findings, histo‐pathological features, and survival. Results Thirty‐seven patients with synchronous CRLM were considered for the liver‐first approach. Twenty‐five patients had rectal cancer. All patients underwent induction chemotherapy. Thirty patients underwent hepatic resections with no post‐operative deaths. Following liver resection, five patients failed to proceed to colorectal resection and one patient had complete response to chemo‐radiotherapy. Of the 25 patients that completed the liver‐first approach, 13 patients had recurrent disease, of which 12 patients died. The overall 1‐ and 3‐year survival rates were 65.9% and 30.4%, respectively. Conclusion The liver‐first approach is a feasible strategy for patients with synchronous CRLM and may improve survival in selected patients. The selection of patients should be incorporated in a multidisciplinary approach to achieve the best possible outcomes. J. Surg. Oncol. 2013; 108:444–449 . © 2013 Wiley Periodicals, Inc.