Epidemiology and Management of Liver Metastases From Colorectal Cancer

Manfrédi, Sylvain; Lepage, Côme; Hatem, Cyril; Coatmeur, Olivier; Faivre, Jean; Bouvier, Anne

doi:10.1097/01.sla.0000217629.94941.cf

Cited by 1,169 publications

(851 citation statements)

References 16 publications

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“…Liver resection for secondary tumor growth is performed mainly in patients with colorectal liver metastases, with resection rates of between 20 and 30% and a 5-year survival rate of 25-58% [11,12]. In contrast, liver resection for hepatic metastasized gastric carcinoma is a rarely performed procedure: resection rates of liver metastases from gastric cancer range from 11 to 21% [5,6].…”

Section: Discussionmentioning

confidence: 99%

Resection of liver metastases is beneficial in patients with gastric cancer: report on 15 cases and review of literature

et al. 2011

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Background Although up to 9% of patients with gastric cancer develop liver metastases, liver resection is rarely performed because of co-existing non-curative factors. Furthermore, the benefit of liver resection is still controversially discussed. Our goal was to investigate the outcome of patients who underwent liver resection or radiofrequency ablation (RFA) for hepatic metastasized gastric cancer. Methods Retrospectively collected data from a prospectively maintained database were analyzed from 15 patients who underwent liver resection or RFA for liver metastases from gastric cancer. Results Overall 5-year survival and median survival were 27% and 48 months for resected/RFA patients. The perioperative complication rate was low. One patient has been tumor-free for 90 months now. Conclusions Liver resection in patients with hepatic metastasized gastric cancer is beneficial and safe if an R0 situation can be achieved. RFA might be a useful alternative in those patients where surgery is not feasible.

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Section: Discussionmentioning

confidence: 99%

Resection of liver metastases is beneficial in patients with gastric cancer: report on 15 cases and review of literature

et al. 2011

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“…It is now known that multiple risk factors contribute to the development of liver metastases, including sex, age, colorectal tumor features, and a variety of genetic abnormalities involved in invasion and metastases (Adachi et al, 1999;Ogawa et al, 2005;Ghadjar et al, 2006;Kuramochi et al, 2006;Manfredi et al, 2006;Shinji et al, 2006;Herynk et al, 2007;Lin et al, 2007). Here, we investigated the effect of a common p53 polymorphism (R72P) on colorectal liver metastases in a Chinese population.…”

Section: Introductionmentioning

confidence: 99%

Association of p53 codon 72 polymorphism with liver metastases of colorectal cancers positive for p53 overexpression

Zhu¹,

Liu

Wang³

et al. 2008

J. Zhejiang Univ. Sci. B

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Abstract:Objective: To evaluate the association between p53 codon 72 polymorphism (R72P) and the risk of colorectal liver metastases. Methods: The p53 R72P genotype was identified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method in 78 consecutive colorectal cancer patients with liver metastases and 214 age-and sex-matched cases with nonmetastatic colorectal cancer. Results: The R allele of the p53 R72P polymorphism was more frequently found in metastatic cases than in nonmetastatic cases (P=0.075). Carriers of the 72R allele had a 2.25-fold (95% CI (confidence interval)=1.05~4.83) increased risk of liver metastases. On the stratification analysis, 72R-carrying genotype conferred a 3.46-fold (95% CI=1.02~11.72) and a 1.05-fold (95% CI=0.36~3.08) increased risk of liver metastases for p53 overexpression-positive and negative colorectal cancers, respectively. Conclusion: These results demonstrate for the first time that the 72R allele of the p53 polymorphism has an increased risk for liver metastases in colorectal cancers positive for p53 overexpression.

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“…Nevertheless, in recent years, the integration of surgery into multimodal treatment protocols has resulted in 5-year survival rates approaching 60 % [2][3][4]. In addition, although 80 % of patients are not considered to be candidates for resection at the time of diagnosis [5], modern chemotherapeutic regimens permit a number of patients to have their disease converted from unresectable to resectable [6,7]. Therefore, accurate detection and localisation of all metastatic deposits is essential to determine the resectability, which is now defined solely according to the possibility to obtain a radical (R0) resection [8].…”

Section: Introductionmentioning

confidence: 99%

Staging of colorectal liver metastases after preoperative chemotherapy. Diffusion-weighted imaging in combination with Gd-EOB-DTPA MRI sequences increases sensitivity and diagnostic accuracy

et al. 2012

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Objectives To compare the diagnostic accuracy and sensitivity of Gd-EOB-DTPA MRI and diffusion-weighted (DWI) imaging alone and in combination for detecting colorectal liver metastases in patients who had undergone preoperative chemotherapy. Methods Thirty-two consecutive patients with a total of 166 liver lesions were retrospectively enrolled. Of the lesions, 144 (86.8 %) were metastatic at pathology. Three image sets (1, Gd-EOB-DTPA; 2, DWI; 3, combined Gd-EOB-DTPA and DWI) were independently reviewed by two observers. Statistical analysis was performed on a per-lesion basis. Results Evaluation of image set 1 correctly identified 127/ 166 lesions (accuracy 76.5 %; 95 % CI 69.3-82.7) and 106/ 144 metastases (sensitivity 73.6 %, 95 % CI 65.6-80.6). Evaluation of image set 2 correctly identified 108/166 (accuracy 65.1 %, 95 % CI 57.3-72.3) and 87/144 metastases (sensitivity of 60.4 %, 95 % CI 51.9-68.5). Evaluation of image set 3 correctly identified 148/166 (accuracy 89.2 %, 95 % CI 83.4-93.4) and 131/144 metastases (sensitivity 91 %, 95 % CI 85.1-95.1). Differences were statistically significant (P<0.001). Notably, similar results were obtained analysing only small lesions (<1 cm). Conclusions The combination of DWI with Gd-EOB-DTPAenhanced MRI imaging significantly increases the diagnostic accuracy and sensitivity in patients with colorectal liver metastases treated with preoperative chemotherapy, and it is particularly effective in the detection of small lesions. Key Points • Accurate detection of colorectal liver metastases is essential to determine resectability.• Almost 80 % of patients are candidates for neoadjuvant chemotherapic treatment at diagnosis. After chemotherapy, metastases usually decrease, and drug-induced liver steatosis may be present.• The sensitivity of imaging is significantly inferior to that in chemotherapy-naïve patients.• DWI combined with Gd-EOB-DTPA increases sensitivity in detecting small metastases after chemotherapy.

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Epidemiology and Management of Liver Metastases From Colorectal Cancer

Abstract: Liver metastases from colorectal cancer remain a substantial problem. More effective treatments and mass screening represent promising approaches to decrease this problem.

Cited by 1,169 publications

References 16 publications

Resection of liver metastases is beneficial in patients with gastric cancer: report on 15 cases and review of literature

Resection of liver metastases is beneficial in patients with gastric cancer: report on 15 cases and review of literature

Association of p53 codon 72 polymorphism with liver metastases of colorectal cancers positive for p53 overexpression

Staging of colorectal liver metastases after preoperative chemotherapy. Diffusion-weighted imaging in combination with Gd-EOB-DTPA MRI sequences increases sensitivity and diagnostic accuracy

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