Interval Period Tumor Progression: Does Delayed Hepatectomy Detect Occult Metastases in Synchronous Colorectal Liver Metastases?

Yoshidome, Hiroyuki; Kimura, Fumio; Shimizu, Hiroaki; Ohtsuka, Masayuki; Kato, Atsushi; Yoshitomi, Hideyuki; Furukawa, Katsunori; Mitsuhashi, Noboru; Takeuchi, Dan; Iida, Ayako; Miyazaki, Masaru

doi:10.1007/s11605-008-0540-9

Cited by 46 publications

(29 citation statements)

References 32 publications

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“…In particular, rapid growth of preexisting metastatic cancer in the liver after resection of the primary colorectal tumor has been noted by several investigators [6,[50][51][52] . Of note, in one investigation the vascular density of metastases has been noted to be significantly increased over the pre-resection baseline several months after primary resection; this suggests that tumor angiogenesis is stimulated after surgery [53] .…”

Section: Discussionmentioning

confidence: 97%

Plasma chitinase 3-like 1 is persistently elevated during first month after minimally invasive colorectal cancer resection

Kumara

Gaita

Miyagaki

et al. 2016

WJGO

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AIM:To assess blood chitinase 3-like 1 (CHi3L1) levels for 2 mo after minimally invasive colorectal resection (MICR) for colorectal cancer (CRC). METHODS: CRC patients in an Institutional ReviewBoard approved data/plasma bank who underwent elective MICR for whom preoperative (PreOp), early postoperative (PostOp), and 1 or more late PostOp samples [postoperative day (POD) 7-27] available were included. Plasma CHi3L1 levels (ng/mL) were determined in RESULTS:PreOp and PostOp plasma sample were available for 80 MICR cancer patients for the study. The median PreOp CHi3L1 level was 56.8 CI: 41.9-78.6 ng/ mL (n = 80). Significantly elevated (P < 0.001) median plasma levels (ng/mL) over PreOp levels were detected on POD1 (667.7 CI: 495.7, 771.7; n = 79), POD 3 (132.6 CI: 95.5, 173.7; n = 76), 136.9; n = 62), 287.4; n = 22), 137.4; n = 20, P = 0.001).No significant difference in plasma levels were noted on POD27-41.CONCLUSION: Plasma CHi3L1 levels were significantly elevated for one month after MICR. Persistently elevated plasma CHi3L1 may support the growth of residual tumor and metastasis.

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Section: Discussionmentioning

confidence: 97%

Plasma chitinase 3-like 1 is persistently elevated during first month after minimally invasive colorectal cancer resection

Kumara

Gaita

Miyagaki

et al. 2016

WJGO

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“…A similar surgical outcome has been reported after simultaneous and delayed (or interval) resection of liver metastases, so simultaneous resection has gained acceptance at some institutions [12][13][14][15][16]. However, several authors have recommended a 'test of time' to assess tumor progression [17][18][19][20] on the basis that delaying the resection of apparently resectable synchronous hepatic metastases for 3-6 months might allow occult disease to become detectable; thus, patients who develop unresectable disease during the interval can be spared from undergoing unnecessary surgery.…”

Section: Introductionmentioning

confidence: 74%

“…The optimal surgical strategy for resectable synchronous LM still remains controversial [12][13][14][15][16][17][18][19][20]. Some authors have proposed a ''test-of-time'' approach to assess the biological behavior of the tumor, identify potential occult disease, and avoid surgery in patients with rapidly progressive cancer [17][18][19][20]. Scheele et al [24] reported a poor prognosis of patients with synchronous metastases, and they attributed some of the blame for the poor outcome to failure to remove hepatic micrometastases in patients undergoing resection of overt liver metastases as part of the primary procedure.…”

Section: Discussionmentioning

confidence: 99%

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Timing of Resection for Synchronous Liver Metastases from Colorectal Cancer

et al. 2010

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Tumor progression could be recognized and occult metastases were detected during the interval between operations. Delayed resection of synchronous LM may be useful to reduce the risk of rapid recurrence in the remnant liver. Patients with poorly differentiated or mucinous adenocarcinoma and those with larger tumors who undergo delayed liver resection should receive neoadjuvant chemotherapy during the interval between operations.

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“…Alternatively, these patients may benefit from neoadjuvant chemotherapy, although there are no data to support this approach. Some advocate a delay in liver resection to allow the biological behavior of the tumor to become evident [83]. No difference in survival outcome was seen in a retrospective review of 73 patients who were either operated on immediately or given a period of observation, although that study was not likely to have detected modest-sized effects [84].…”

Section: What Is the Optimal Timing Of Liver Resection?mentioning

confidence: 99%

Curative Strategies for Liver Metastases from Colorectal Cancer: A Review

et al. 2012

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After completing this course, the reader will be able to:1. Among patients with liver metastases from colorectal cancer, determine which would benefit from liver resection, the timing for surgery, and an appropriate perioperative chemotherapy regimen.2. Determine which patients are candidates for perioperative chemotherapy and the appropriate timing of chemotherapy, and describe the relevant toxicities and their impact on morbidity and mortality.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTColorectal cancer is a very common malignancy and frequently manifests with liver metastases, often without other systemic disease. Margin-negative (R0) resection of limited metastatic disease, in conjunction with systemic antineoplastic agents, is the primary treatment strategy, leading to long survival times for appropriately selected patients. There is debate over whether the primary tumor and secondaries should be removed at the same time or in a staged manner. Chemotherapy is effective in converting some unresectable liver metastases into resectable disease, with a correspondingly better survival outcome. However, the ideal chemotherapy with or without biological agents and when it should be administered in the course of treatment are uncertain. The role of neoadjuvant chemotherapy in initially resectable liver metastases is controversial. Local delivery of chemotherapy, with and without surgery, can lead to longer disease-free survival times, but it is not routinely used with curative intent. This review focuses on methods to maximize the disease-free survival interval using chemotherapy, surgery, and local methods. The Oncologist 2012;17:201-211

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Interval Period Tumor Progression: Does Delayed Hepatectomy Detect Occult Metastases in Synchronous Colorectal Liver Metastases?

Abstract: Tumor progression was recognized and occult metastases were detected after the interval reevaluation. Delayed hepatectomy may be a useful approach to reduce rapid remnant liver recurrence in synchronous CRLM.

Cited by 46 publications

References 32 publications

Plasma chitinase 3-like 1 is persistently elevated during first month after minimally invasive colorectal cancer resection

Plasma chitinase 3-like 1 is persistently elevated during first month after minimally invasive colorectal cancer resection

Timing of Resection for Synchronous Liver Metastases from Colorectal Cancer

Curative Strategies for Liver Metastases from Colorectal Cancer: A Review

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