Resection of colorectal liver metastases

Scheele, J.; Stang, Richard; Altendorf-Hofmann, A.; Paul, Martin G.

doi:10.1007/bf00316981

Cited by 1,449 publications

(1,008 citation statements)

References 34 publications

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“…Eighteen of these were single publications (Savage and Malt, 1992;Sugihara et al, 1993; Donato et al, 1994; Doci et al, 1995; Fernandez-Trigo et al, 1995; Fuhrman et al, 1995; Beckurts et al, 1997;Rees et al, 1997; Cady et al, 1998; Ohlsson et al, 1998;Riesener et al, 1998; Bradley et al, 1999; Harmon et al, 1999; Harms et al, 1999; Kemeny et al, 1999a; Bolton and Fuhrman, 2000; Okano et al, 2000; Moroz et al, 2002) and in a further 12 cases the data was obtained from multiple publications (Hughes et al, 1988(Hughes et al, , 1989 Hohenberger et al, 1990 Hohenberger et al, , 1994Scheele et al, 1990Scheele et al, , 1991Scheele et al, , 1995Scheele et al, , 1996Steele Jr et al, 1991Rosen et al, 1992; Gayowski et al, 1994;Stangl et al, 1994; Fong et al, 1995 Fong et al, , 1997 Fong et al, , 1999 Leslie et al, 1995; Jamison et al, 1996 Jamison et al, , 1997 Jenkins et al, 1997; Bakalakos et al, 1998a, b; Iwatsuki et al, 1999; Minagawa et al, 1999; Ambiru et al, 1999a; Kemeny et al, 1999b, c; Brand et al, 2000; DeMatteo et al, 2000; Minagawa et al, 2000). In addition, data on 30-day mortality and morbidity were included from a further nine studies (one with two publications) in which survival data was excluded owing to insufficient or unclear follow up (Minton and Abou-Issa, 1990; Fegiz et al, 1991; Nordlinger et al, 1992;van Ooijen et al, 1992;Wade et al, 1996; Lorenz et al, 1997 Lorenz et al, , 1998; Nadig et al, 1997; Taylor Just two studies included all patients presenting with colorectal liver metastases (Scheele et al, 1990(Scheele et al, , 1991(Scheele et al, , 1995(Scheele et al, , 1996Stangl et al, 1994; Harms et al, 1999) and only three studies presented data on all patients undergoing surgery (radical, nonradical and laparotomy) (Steele Jr et al, 1991 Fuhrman et al, 1995; Bakalakos et al, 1998a). The majority (27) of studies presented data on resected patients, but while some studies distinguished between R0 resections (no residual disease, histologically clear margins), R1 (histologically involved margins) and R2 resections (macroscopic residual disease), in many this was unclear.…”

Section: Description Of Studies Identifiedmentioning

confidence: 99%

Section: Description Of Studies Identifiedmentioning

confidence: 99%

“…The selection criteria for surgery are usually controlled primary tumour, no extra hepatic metastases and that resection is technically feasible with tumour-free margins (Hugh et al, 1997b). A small proportion of patients with completely resectable extrahepatic disease may become long-term survivors (Scheele et al, 1995). Chemotherapy used alone is palliative but may prolong the survival of patients with unresectable disease (de Gramont et al, 2000; Douillard et al, 2000;Saltz et al, 2000;Simmonds, 2000).…”

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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: Description Of Studies Identifiedmentioning

confidence: 99%

Section: Description Of Studies Identifiedmentioning

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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“…In these patients the liver is the major site of metastatic disease (Sugarbaker, 1994). Patients with resectable liver metastases may have a partial hepatectomy with a 5 year survival rate of 25 -30% (Hughes, 1988;Steele and Ravikumar, 1989;Scheele et al, 1995). On the other hand the natural history of patients with untreated liver metastases shows a 5-year survival rate of 0 -3% (Wood et al, 1976).…”

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Prerequisites for effective adenovirus mediated gene therapy of colorectal liver metastases in the rat using an intracellular neutralizing antibody fragment to p21-Ras

et al. 2002

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Ras mutations are present in 40 -50% of colorectal cancers. Inactivating this oncogene may therefore reduce proliferation capacity. In order to target ras we studied the transduction efficacy and anti tumour activity of an adenoviral vector expressing an intracellular, neutralizing single chain antibody to p21-ras (Y28). In in vitro studies transfection levels of the K-ras mutated rat colon carcinoma cell line CC531 were studied using the LacZ marker gene. In our in vivo liver metastases model different routes of administration were evaluated to determine which regimen resulted in the best transfection levels and tumour responses: intravenous injection, intratumoural injection, isolated liver perfusion, or hepatic artery infusion. CC531 cells are readily transfected in vitro, resulting in significant inhibition of tumour cell proliferation by the Y28 construct. Intravenous injection did not result in any measurable transfection. Intratumoural injection resulted only in the transfection of tumour cells along the needle track. IHP as well as single HAI achieved low transfection levels of tumour tissue. Expression of Y28 was demonstrated in tumours after IT injection, HAI and IHP. Whereas, repeated HAI's clearly achieved expression in and around tumour associated vessels. Only five times repeated HAI's with Y28 resulted in a tumour response: in all animals tumour growth was inhibited, and in three rats out of eight a complete regression of the liver tumours was observed.

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“…Liver resection of localized disease gives 5-year survival rates of 20-40% for primary or colorectal liver cancer (Hughes et al, 1988;Farmer et al, 1994;Scheele et al, 1995). Adjuvant chemotherapy has been shown to improve survival after curative resection of colon carcinoma (Moertel et al, 1990), but has not been demonstrated to give a survival advantage after curative resection of colorectal liver metastases (August et al, 1985).…”

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Comparison between interstitial laser thermotherapy and excision of an adenocarcinoma transplanted into rat liver

Möller

Ivarsson²,

Stenram³

et al. 1998

Br J Cancer

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Summary The aim of this study was to compare interstitial laser thermotherapy with excision of a liver tumour. A dimethylhydrazine-induced adenocarcinoma was transplanted (implanted if not stated otherwise) into the left lateral lobe of the rat liver, and treatment was performed 8 days later. In the main experiment, rats were treated with resection of the tumour-bearing lobe or underwent interstitial laser thermotherapy, which was performed at a steady-state temperature of 460C for 30 min, 3 mm from the tumour margin. The incidence and extent of intraperitoneal spread was smaller after laser thermotherapy than after resection of the tumour-bearing lobe, with no difference in local control. Metastatic spread after resection of the median liver lobe was similar to that observed after sham procedures for thermotherapy or resection, suggesting that the advantage of thermotherapy was not due to a difference in surgical trauma. Additional studies showed that laser thermotherapy reduced intraperitoneal spread when treatment was suboptimal or in a tumour inoculation model and suggested that immunological mechanisms might be involved. It is concluded that interstitial laser thermotherapy reduces spread of liver tumour compared with resection.

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Resection of colorectal liver metastases

Cited by 1,449 publications

References 34 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

Prerequisites for effective adenovirus mediated gene therapy of colorectal liver metastases in the rat using an intracellular neutralizing antibody fragment to p21-Ras

Comparison between interstitial laser thermotherapy and excision of an adenocarcinoma transplanted into rat liver

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