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Outcomes of liver-first strategy and classical strategy for synchronous colorectal liver metastases in Sweden

Valdimarsson, Valentinus T. LU ; Syk, Ingvar LU ; Lindell, Gert LU ; Norén, Agneta; Isaksson, Bengt; Sandström, Per; Rizell, Magnus; Ardnor, Bjarne and Sturesson, Christian LU (2017) In HPB
Abstract

Background: Patients with synchronous colorectal liver metastases (sCRLM) are increasingly operated with liver resection before resection of the primary cancer. The aim of this study was to compare outcomes in patients following the liver-first strategy and the classical strategy (resection of the bowel first) using prospectively registered data from two nationwide registries. Methods: Clinical, pathological and survival outcomes were compared between the liver-first strategy and the classical strategy (2008-2015). Overall survival was calculated. Results: A total of 623 patients were identified, of which 246 were treated with the liver-first strategy and 377 with the classical strategy. The median follow-up was 40 months. Patients... (More)

Background: Patients with synchronous colorectal liver metastases (sCRLM) are increasingly operated with liver resection before resection of the primary cancer. The aim of this study was to compare outcomes in patients following the liver-first strategy and the classical strategy (resection of the bowel first) using prospectively registered data from two nationwide registries. Methods: Clinical, pathological and survival outcomes were compared between the liver-first strategy and the classical strategy (2008-2015). Overall survival was calculated. Results: A total of 623 patients were identified, of which 246 were treated with the liver-first strategy and 377 with the classical strategy. The median follow-up was 40 months. Patients chosen for the classical strategy more often had T4 primary tumours (23% vs 14%, P = 0.012) and node-positive primaries (70 vs 61%, P = 0.015). The liver-first patients had a higher liver tumour burden score (4.1 (2.5-6.3) vs 3.6 (2.2-5.1), P = 0.003). No difference was seen in five-year overall survival between the groups (54% vs 49%, P = 0.344). A majority (59%) of patients with rectal cancer were treated with the liver-first strategy. Conclusion: The liver-first strategy is currently the dominant strategy for sCRLM in patients with rectal cancer in Sweden. No difference in overall survival was noted between strategies.

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organization
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publication status
epub
subject
in
HPB
publisher
Informa Healthcare
external identifiers
  • scopus:85037599475
ISSN
1365-182X
DOI
10.1016/j.hpb.2017.11.004
language
English
LU publication?
yes
id
d0771cbf-b0ea-4e1c-9584-cae94b5c4f91
date added to LUP
2018-01-10 14:58:33
date last changed
2018-01-11 03:00:03
@article{d0771cbf-b0ea-4e1c-9584-cae94b5c4f91,
  abstract     = {<p>Background: Patients with synchronous colorectal liver metastases (sCRLM) are increasingly operated with liver resection before resection of the primary cancer. The aim of this study was to compare outcomes in patients following the liver-first strategy and the classical strategy (resection of the bowel first) using prospectively registered data from two nationwide registries. Methods: Clinical, pathological and survival outcomes were compared between the liver-first strategy and the classical strategy (2008-2015). Overall survival was calculated. Results: A total of 623 patients were identified, of which 246 were treated with the liver-first strategy and 377 with the classical strategy. The median follow-up was 40 months. Patients chosen for the classical strategy more often had T4 primary tumours (23% vs 14%, P = 0.012) and node-positive primaries (70 vs 61%, P = 0.015). The liver-first patients had a higher liver tumour burden score (4.1 (2.5-6.3) vs 3.6 (2.2-5.1), P = 0.003). No difference was seen in five-year overall survival between the groups (54% vs 49%, P = 0.344). A majority (59%) of patients with rectal cancer were treated with the liver-first strategy. Conclusion: The liver-first strategy is currently the dominant strategy for sCRLM in patients with rectal cancer in Sweden. No difference in overall survival was noted between strategies.</p>},
  author       = {Valdimarsson, Valentinus T. and Syk, Ingvar and Lindell, Gert and Norén, Agneta and Isaksson, Bengt and Sandström, Per and Rizell, Magnus and Ardnor, Bjarne and Sturesson, Christian},
  issn         = {1365-182X},
  language     = {eng},
  publisher    = {Informa Healthcare},
  series       = {HPB},
  title        = {Outcomes of liver-first strategy and classical strategy for synchronous colorectal liver metastases in Sweden},
  url          = {http://dx.doi.org/10.1016/j.hpb.2017.11.004},
  year         = {2017},
}