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Liver-first strategy for synchronous colorectal liver metastases : an intention-to-treat analysis

Sturesson, Christian LU ; Valdimarsson, Valentinus T. LU ; Blomstrand, Erik; Eriksson, Sam LU ; Nilsson, Jan LU ; Syk, Ingvar LU and Lindell, Gert LU (2017) In HPB 19(1). p.52-58
Abstract

Background The liver-first strategy signifies resection of liver metastases before the primary colorectal cancer. The aim of the present study was to compare failure to complete intended treatment and survival in liver-first and classical strategies. Methods All patients with colorectal cancer and synchronous liver metastases planned for sequential radical surgery in a single institution between 2011 and 2015 were included. Results A total of 109 patients were presented to a multidisciplinary team conference (MDT) with un-resected colorectal cancer and synchronous liver metastases. Seventy-five patients were planned as liver-first, whereas 34 were recommended the classical strategy. Twenty-six patients (35%) failed to complete treatment... (More)

Background The liver-first strategy signifies resection of liver metastases before the primary colorectal cancer. The aim of the present study was to compare failure to complete intended treatment and survival in liver-first and classical strategies. Methods All patients with colorectal cancer and synchronous liver metastases planned for sequential radical surgery in a single institution between 2011 and 2015 were included. Results A total of 109 patients were presented to a multidisciplinary team conference (MDT) with un-resected colorectal cancer and synchronous liver metastases. Seventy-five patients were planned as liver-first, whereas 34 were recommended the classical strategy. Twenty-six patients (35%) failed to complete treatment in the liver-first group compared to 10 patients in the classical group (P = 0.664). Reason for failure was most commonly disease progression. A total of 91 patients had the primary tumor resected before the liver metastases of which 67 before referral and 24 after allocation at MDT. Median survival after diagnosis in this group was 60 (48–73) months compared to 46 (31–60) months in the group operated with liver-first strategy (n = 49), (P = 0.310). Discussion Up to 35% of patients with colorectal cancer and synchronous liver metastases do not complete the intended treatment of liver and bowel resections, irrespective of treatment strategy.

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author
organization
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type
Contribution to journal
publication status
published
subject
in
HPB
volume
19
issue
1
pages
7 pages
publisher
Informa Healthcare
external identifiers
  • scopus:85010404678
  • wos:000394193100010
ISSN
1365-182X
DOI
10.1016/j.hpb.2016.10.005
language
English
LU publication?
yes
id
25d301c6-23f0-4d37-a8b9-91a8b688e0e3
date added to LUP
2017-02-22 15:54:09
date last changed
2018-05-06 04:31:13
@article{25d301c6-23f0-4d37-a8b9-91a8b688e0e3,
  abstract     = {<p>Background The liver-first strategy signifies resection of liver metastases before the primary colorectal cancer. The aim of the present study was to compare failure to complete intended treatment and survival in liver-first and classical strategies. Methods All patients with colorectal cancer and synchronous liver metastases planned for sequential radical surgery in a single institution between 2011 and 2015 were included. Results A total of 109 patients were presented to a multidisciplinary team conference (MDT) with un-resected colorectal cancer and synchronous liver metastases. Seventy-five patients were planned as liver-first, whereas 34 were recommended the classical strategy. Twenty-six patients (35%) failed to complete treatment in the liver-first group compared to 10 patients in the classical group (P = 0.664). Reason for failure was most commonly disease progression. A total of 91 patients had the primary tumor resected before the liver metastases of which 67 before referral and 24 after allocation at MDT. Median survival after diagnosis in this group was 60 (48–73) months compared to 46 (31–60) months in the group operated with liver-first strategy (n = 49), (P = 0.310). Discussion Up to 35% of patients with colorectal cancer and synchronous liver metastases do not complete the intended treatment of liver and bowel resections, irrespective of treatment strategy.</p>},
  author       = {Sturesson, Christian and Valdimarsson, Valentinus T. and Blomstrand, Erik and Eriksson, Sam and Nilsson, Jan and Syk, Ingvar and Lindell, Gert},
  issn         = {1365-182X},
  language     = {eng},
  month        = {01},
  number       = {1},
  pages        = {52--58},
  publisher    = {Informa Healthcare},
  series       = {HPB},
  title        = {Liver-first strategy for synchronous colorectal liver metastases : an intention-to-treat analysis},
  url          = {http://dx.doi.org/10.1016/j.hpb.2016.10.005},
  volume       = {19},
  year         = {2017},
}