The liver-first approach for synchronous colorectal liver metastases: A systematic review and meta-analysis of completion rates and effects on survival
(2021) In Scandinavian Journal of Surgery- Abstract
- Background: Patients presenting with synchronous colorectal liver metastases are increasingly
being considered for a curative treatment, and the liver-first approach is gaining popularity in this
context. However, little is known about the completion rates of the liver-first approach and its
effects on survival.
Methods:A systematic review and meta-analysis of liver-first strategy for colorectal liver metastasis.
The primary outcome was an assessment of the completion rates of the liver-first approach.
Secondary outcomes included overall survival, causes of non-completion, and clinicopathologic
data.
Results: Seventeen articles were amenable for inclusion and the total study population was 1041.
The... (More) - Background: Patients presenting with synchronous colorectal liver metastases are increasingly
being considered for a curative treatment, and the liver-first approach is gaining popularity in this
context. However, little is known about the completion rates of the liver-first approach and its
effects on survival.
Methods:A systematic review and meta-analysis of liver-first strategy for colorectal liver metastasis.
The primary outcome was an assessment of the completion rates of the liver-first approach.
Secondary outcomes included overall survival, causes of non-completion, and clinicopathologic
data.
Results: Seventeen articles were amenable for inclusion and the total study population was 1041.
The median completion rate for the total population was 80% (range 20–100). The median overall
survival for the completion and non-completion groups was 45 (range 12–69) months and 13 (range
10.5–25) months, respectively. Metadata showed a significant survival benefit for the completion
group, with a univariate hazard ratio of 12.0 (95% confidence interval, range 5.7–24.4). The major
cause of non-completion (76%) was liver disease progression before resection of the primary
tumor. Pearson tests showed significant negative correlation between median number of lesions
and median size of the largest metastasis and completion rate.
Conclusions: The liver-first approach offers a complete resection to most patients enrolled, with
an overall survival benefit when completion can be assured. One-fifth fails to return to intended
oncologic therapy and the major cause is interim metastatic progression, most often in the liver.
Risk of non-completion is related to a higher number of lesions and large metastases. The majority
of studies stem from primary (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/0a69d701-9393-4d78-a737-88a3d5f7270d
- author
- Zeyara, Adam
LU
; Torén, William LU ; Søreide, Kjetil and Andersson, Roland LU
- organization
- publishing date
- 2021-10-03
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Scandinavian Journal of Surgery
- article number
- 14574969211030131
- publisher
- Finnish Surgical Society
- external identifiers
-
- pmid:34605325
- scopus:85116335868
- ISSN
- 1799-7267
- DOI
- 10.1177/14574969211030131
- language
- English
- LU publication?
- yes
- id
- 0a69d701-9393-4d78-a737-88a3d5f7270d
- date added to LUP
- 2021-10-27 21:13:48
- date last changed
- 2022-08-05 08:19:58
@article{0a69d701-9393-4d78-a737-88a3d5f7270d, abstract = {{Background: Patients presenting with synchronous colorectal liver metastases are increasingly<br/>being considered for a curative treatment, and the liver-first approach is gaining popularity in this<br/>context. However, little is known about the completion rates of the liver-first approach and its<br/>effects on survival.<br/>Methods:A systematic review and meta-analysis of liver-first strategy for colorectal liver metastasis.<br/>The primary outcome was an assessment of the completion rates of the liver-first approach.<br/>Secondary outcomes included overall survival, causes of non-completion, and clinicopathologic<br/>data.<br/>Results: Seventeen articles were amenable for inclusion and the total study population was 1041.<br/>The median completion rate for the total population was 80% (range 20–100). The median overall<br/>survival for the completion and non-completion groups was 45 (range 12–69) months and 13 (range<br/>10.5–25) months, respectively. Metadata showed a significant survival benefit for the completion<br/>group, with a univariate hazard ratio of 12.0 (95% confidence interval, range 5.7–24.4). The major<br/>cause of non-completion (76%) was liver disease progression before resection of the primary<br/>tumor. Pearson tests showed significant negative correlation between median number of lesions<br/>and median size of the largest metastasis and completion rate.<br/>Conclusions: The liver-first approach offers a complete resection to most patients enrolled, with<br/>an overall survival benefit when completion can be assured. One-fifth fails to return to intended<br/>oncologic therapy and the major cause is interim metastatic progression, most often in the liver.<br/>Risk of non-completion is related to a higher number of lesions and large metastases. The majority<br/>of studies stem from primary}}, author = {{Zeyara, Adam and Torén, William and Søreide, Kjetil and Andersson, Roland}}, issn = {{1799-7267}}, language = {{eng}}, month = {{10}}, publisher = {{Finnish Surgical Society}}, series = {{Scandinavian Journal of Surgery}}, title = {{The liver-first approach for synchronous colorectal liver metastases: A systematic review and meta-analysis of completion rates and effects on survival}}, url = {{http://dx.doi.org/10.1177/14574969211030131}}, doi = {{10.1177/14574969211030131}}, year = {{2021}}, }