OncoSurge: A Strategy for Improving Resectability With Curative Intent in Metastatic Colorectal Cancer

Poston, Graeme J.; Adam, René; Alberts, Steven R.; Curley, Steven A.; Figueras, Juan; Haller, Daniel G.; Kunstlinger, F; Mentha, Gilles; Nordlinger, Bernard; Patt, Yehuda Z.; Primrose, John; Roh, Mark S.; Rougier, Philippe; Ruers, Theo; Schmoll, Hans Joachim; Valls, Carlos; Vauthey, Nick Jean Nicolas; Cornelis, Marleen; Kahan, James P.

doi:10.1200/jco.2005.08.722

Cited by 243 publications

(144 citation statements)

References 41 publications

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“…These factors will almost certainly impact increasingly on the reported outcomes after 2000 (Poston et al, 2005). Firstly modern chemotherapy using cytotoxic agents alone offers extension of median survival to 2 years in patients with nonresectable disease (Cals et al, 2004; Goldberg et al, 2004; Grothey et al, 2004;Tournigand et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

“…It is therefore inevitable that the combination of surgical resection and chemotherapy, which is becoming commonplace, will impact on the survival in the surgical series. The EORTC EPOC trial which is the first to randomise liver resection patients to receive additional, modern, chemotherapy is due for reporting in 2007 (Nordlinger et al, 2005). Secondly, novel surgical strategies such as preoperative portal vein embolisation to increase residual acceptably safe volume, or two-stage hepatectomy to allow compensatory hepatic hyperplasia before completion of R0 resection (Abdalla et al, 2002;Pawlik et al, 2005;Poston et al, 2005), have also widened the number of resectable patients including those with extensive liveronly disease.…”

Section: Discussionmentioning

confidence: 99%

“…These changes in the definition of resectability means that 420% of patients with liver metastases can now be considered for surgery with curative intent at the outset. It is unclear what the long-term outcome of these strategies will be but the results appear encouraging (Abdalla et al, 2002;Pawlik et al, 2005;Poston et al, 2005). This present review should both set the standard for the reporting of subsequent surgical series and provide baseline results to which they may be compared.…”

Section: Discussionmentioning

confidence: 99%

“…There was patchy reporting of the causes of postoperative death, with the most frequent causes being hepatic failure, postoperative haemorrhage, and sepsis. It is likely that current surgical and anaesthetic practice is associated with perioperative mortalities nearer to 1% as demonstrated in a recent multicentre trial (Nordlinger et al, 2005). Operative morbidity was more difficult to quantify as many studies reported only fatal Proportion of patients with recurrence in the liver only not specified.…”

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Surgical resection of hepatic metastases from colorectal cancer: A systematic review of published studies

et al. 2006

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No consensus on the indications for surgical resection of colorectal liver metastases exists. This systematic review has been undertaken to assess the published evidence for its efficacy and safety and to identify prognostic factors. Studies were identified by computerised and hand searches of the literature, scanning references and contacting investigators. The outcome measures were overall survival, disease-free survival, postoperative morbidity and mortality, quality of life and cost effectiveness, and a qualitative summary of the trends across all studies was produced. Only 30 of 529 independent studies met all the eligibility criteria for the review, and data on 30-day mortality and morbidity only were included from a further nine studies. The best available evidence came from prospective case series, but only two studies reported outcomes for all patients undergoing surgery. The remainder reported outcomes for selected groups of patients: those undergoing hepatic resection or those undergoing curative resection. Postoperative mortality rates were generally low (median 2.8%). The majority of studies described only serious postoperative morbidity, the most common being bile leak and associated perihepatic abscess. Approximately 30% of patients remained alive 5 years after resection and around two-thirds of these are disease free. The quality of the majority of published papers was poor and ascertaining the benefits of surgical resection of colorectal hepatic metastases is difficult in the absence of randomised trials. However, it is clear that there is group of patients with liver metastases who may become long-term disease-free survivors following hepatic resection. Such survival is rare in apparently comparable patients who do not have surgical treatment. Further work is needed to more accurately define this group of patients and to determine whether the addition of adjuvant treatments results in improved survival. Colorectal cancer is the third most common cause of cancer death in the UK (Cancer Research UK Information Resource Centre, 2003). Surgery is the treatment of choice for patients with localised disease but over half of all patients will develop metastases. The liver is often the first site of metastatic disease and may be the only site of spread in as many as 30 -40% of patients with advanced disease (Weiss et al, 1986; Hugh et al, 1997a).It has been postulated that because haematogenous spread usually occurs in a stepwise fashion, initially to the liver, with subsequent intrahepatic spread via the portal vein and further spread to the systemic circulation, surgical resection of isolated hepatic metastases from colorectal cancer may be curative.The natural history of metastatic colorectal cancer is variable, with a median survival without treatment of only 8 months (Seymour et al, 1997;Simmonds, 2000). Patients with isolated hepatic metastases have a better prognosis than those with more extensive metastatic disease (Goslin et al, 1982; Lahr et al, 1983;Stangl et al, 1994;Rougier et al, 1995) s...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Surgical resection of hepatic metastases from colorectal cancer: A systematic review of published studies

et al. 2006

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“…Liver resection is firmly established as the treatment of choice for operable primary and secondary liver tumours (1)(2)(3)(4)(5)(6)(7). Despite significant improvements in techniques of hepatic resection, anaesthetic interventions and peri-operative care, liver failure remains a serious but rare complication after major liver resection.…”

Section: Introductionmentioning

confidence: 99%

Perioperative use of the LiMON method of indocyanine green elimination measurement for the prediction and early detection of post-hepatectomy liver failure

Carino

O’Reilly

Dajani

et al. 2009

European Journal of Surgical Oncology (EJSO)

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This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Perioperative Carcinoembryonic Antigen Measurements to Predict Curability After Liver Resection for Colorectal Metastases

Oussoultzoglou

Rosso²,

Fuchshuber³

et al. 2008

Arch Surg

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OncoSurge: A Strategy for Improving Resectability With Curative Intent in Metastatic Colorectal Cancer

Abstract: The results were incorporated into a decision matrix, creating a computer program (OncoSurge). This model identifies individual patient resectability, recommending optimal treatment strategies. It may also be used for medical education.

Cited by 243 publications

References 41 publications

Surgical resection of hepatic metastases from colorectal cancer: A systematic review of published studies

Surgical resection of hepatic metastases from colorectal cancer: A systematic review of published studies

Perioperative use of the LiMON method of indocyanine green elimination measurement for the prediction and early detection of post-hepatectomy liver failure

Perioperative Carcinoembryonic Antigen Measurements to Predict Curability After Liver Resection for Colorectal Metastases

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