Oncological strategies for middle and low rectal cancer with synchronous liver metastases

Sabbagh, Charles; Cossé, Cyril; Ravololoniaina, T.; Chauffert, Bruno; Joly, Jean‐Paul; Mauvais, F.; Régimbeau, Jean-Marc

doi:10.1016/j.ijsu.2015.08.034

Cited by 12 publications

(4 citation statements)

References 23 publications

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“…The morbidity and mortality rates after SR of rectal tumor and liver metastases were not significantly higher than in patients with synchronous liver metastases from rectal cancer who underwent SgR. These results, consistent with similar recent reports on this subject (9,20), confirm that even when the primary tumor is confined to the rectum, the SR could be safely performed in selected patients, treated in high-volume centers.…”

Section: Discussionsupporting

confidence: 88%

Comparative Analysis between Simultaneous Resection and Staged Resection for Synchronous Colorectal Liver Metastases - A Single Center Experience on 300 Consecutive Patients

Alexandrescu¹,

Diaconescu²,

Ionel³

et al. 2017

chr

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Section: Discussionsupporting

confidence: 88%

Comparative Analysis between Simultaneous Resection and Staged Resection for Synchronous Colorectal Liver Metastases - A Single Center Experience on 300 Consecutive Patients

Alexandrescu¹,

Diaconescu²,

Ionel³

et al. 2017

chr

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“…A previous study showed that for patients with synchronous rectal liver metastases the complications of simultaneous resection were 58.3%, but only 29.6% of patients underwent staged resection. 13 A study in South Korea also showed that the incidence of postoperative complications was 76.4% in simultaneous resection combined with large-scale hepatectomy, and even as high as 87.0% in large-scale hepatectomy combined with rectal surgery. 14 The latest meta-analysis of 10,848 patients (including 1 prospective and 43 retrospective studies) showed that the simultaneous resection had the highest postoperative severe complications and mortality within 30 days, but the OS was better than the first resection of liver metastases, which is comparable to the group that resected the primary colorectal tumor first.…”

Section: Discussionmentioning

confidence: 97%

Role of Surgical Approach to Synchronous Colorectal Liver Metastases: A Retrospective Analysis

Zhai¹,

Sun

Du³

et al. 2021

CMAR

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Purpose This study is a retrospective analysis of exploring the efficiency of surgical management on patients with synchronous colorectal liver metastasis (SCLM). Patients and Methods Nine hundred fifty-three consecutive patients with SCLM from Weifang People’s Hospital of Shandong Province between January 2006 and December 2015 were reviewed. The values of different factors were analyzed, such as different surgical indications of liver metastases, simultaneous or staged resection of primary colorectal cancer and liver metastases, and primary tumor resection (PTR) of asymptomatic patients with unresectable liver metastases. Results Median survival time (47.3 months) and 5-year survival rate (31%) for patients with resected liver metastases were significantly superior to that of with nonoperative treatment (17.2 months, 4%, P<0.001); enlarging the standard of liver metastases resection can improve the resection rates (31.0% vs 13.6%, P<0.001); for patients with resectable liver metastases, the in-hospital cost for simultaneous resection group was lower than that in the staged resection group (36,698 vs 45,134 RMB, P<0.001); for patients of the asymptomatic primary tumor with unresectable liver metastases, PTR was associated with improved median survival (18.0 vs 15.0 months, P=0.006). Conclusion For patients with SCLM, liver resection is considered the best treatment; expanding indications of liver resection can improve the resection rates. Simultaneous resection of the primary tumor and liver metastases were indicated in patients with resectable SCLM; PTR was recommended for asymptomatic patients with unresectable hepatic metastases.

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“…Currently, the treatment of colorectal liver metastases (CRLM) remains a major clinical challenge without a consensus[ 20 ]. The case-by-case treatment strategy is determined according to: (1) Tumor and disease-related characteristics, patient-related factors, and treatment-related factors such as toxicity and main oncological problems; (2) presence or absence of predictive factors for rectal and liver resection morbidity; and (3) response to initial CT. New regional and systemic chemotherapies associated with biological agents combined with technical advances in liver surgery have made it possible to broaden indications for CRLM resection by offering personalized treatment.…”

Section: Discussionmentioning

confidence: 99%

Organ sparing to cure stage IV rectal cancer: A case report and review of literature

Meillat,

Garnier,

Palen

et al. 2023

World J Gastrointest Surg

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BACKGROUND Rectal sparing is an option for some rectal cancers with complete or good response after chemoradiotherapy (CRT); however, it has never been evaluated in patients with metastases. We assessed long-term outcomes of a rectal-sparing approach in a liver-first strategy for patients with rectal cancer with resectable liver metastases. CASE SUMMARY We examined patients who underwent an organ-sparing approach for rectal cancer with synchronous liver metastases using a liver-first strategy during 2010-2015 (n = 8). Patients received primary chemotherapy and pelvic CRT. Liver surgery was performed during the interval between CRT completion and rectal tumor re-evaluation. Clinical and oncological characteristics and long-term outcomes were assessed. All patients underwent liver metastatic resection with curative intent. The R0 rate was 100%. Six and two patients underwent local excision and a watch-and-wait (WW) approach, respectively. All patients had T3N1 tumors at diagnosis and had good clinical response after CRT. The median survival time was 60 (range, 14-127) mo. Three patients were disease free for 5, 8, and 10 years after the procedure. Five patients developed metastatic recurrence in the liver (n = 5) and/or lungs (n = 2). Only one patient developed local recurrence concurrent with metastatic recurrence 24 mo after the WW approach. Two patients died during follow-up. CONCLUSION The results suggest good local control in patients undergoing organ-sparing strategies for rectal cancer with synchronous liver metastasis. Prospective trials are required to validate these data and identify good candidates for these strategies.

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Oncological strategies for middle and low rectal cancer with synchronous liver metastases

Cited by 12 publications

References 23 publications

Comparative Analysis between Simultaneous Resection and Staged Resection for Synchronous Colorectal Liver Metastases - A Single Center Experience on 300 Consecutive Patients

Comparative Analysis between Simultaneous Resection and Staged Resection for Synchronous Colorectal Liver Metastases - A Single Center Experience on 300 Consecutive Patients

Role of Surgical Approach to Synchronous Colorectal Liver Metastases: A Retrospective Analysis

Organ sparing to cure stage IV rectal cancer: A case report and review of literature

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