Surgical management of patients with colorectal cancer and simultaneous liver and lung metastases

Andrès, Axel; Mentha, Gilles; Adam, René; Gerstel, Eric; Скипенко, О Г; Barroso, Eduardo; López‐Ben, Santiago; Hubert, Catherine; Majno, Pietro; Toso, Christian

doi:10.1002/bjs.9783

Cited by 98 publications

(87 citation statements)

References 39 publications

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“…Patients with many types of cancer are at high risk of liver metastases. Moreover, tumors originating from intra‐abdominal organs, such as those of the stomach, pancreas, colon, gallbladder, bile duct, and ovary, often exhibit both peritoneal dissemination and liver metastasis . Together with the findings of our previous study , the results obtained in this study suggest that the i.p.…”

Section: Discussionsupporting

confidence: 85%

Therapy of primary and metastatic liver cancer by human iPS cell‐derived myeloid cells producing interferon‐β

Sakisaka

Haruta

Komohara

et al. 2017

J Hepato Biliary Pancreat

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Section: Discussionsupporting

confidence: 85%

Therapy of primary and metastatic liver cancer by human iPS cell‐derived myeloid cells producing interferon‐β

Sakisaka

Haruta

Komohara

et al. 2017

J Hepato Biliary Pancreat

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“…De Haas et al reported a 5‐year OS for patients with liver metastases of 58% in the time period from 2000 to 2010. Similarly, data from the LiverMetSurvey registry showed a 5‐year OS rate for patients with liver metastases of 49.6% for the period from 2008 to 2012 . For the same time interval, patients who were treated for simultaneous lung metastases and were able to achieve an R0 resection at both sites exhibited a 5‐year OS of 41%.…”

Section: Discussionmentioning

confidence: 87%

Prognosis in patients with synchronous colorectal cancer metastases after complete resection of the primary tumor and the metastases

Radulova-Mauersberger

Zschuppe

Kittner

et al. 2019

Journal of Surgical Oncology

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Background Synchronous metastases are considered a negative prognostic factor in patients with metastatic colorectal cancer (CRC). We investigated the outcomes of stage IV CRC patients undergoing complete gross resection (R0/1) of both the primary tumor and the metastases under the guidance of a multidisciplinary team (MDT). Methods All CRC patients with synchronous metastases were retrieved from a prospective database. Patients treated from 2006 to 2017 who underwent complete resection were analyzed. Various factors, including multiple metastatic sites and complex procedures, were investigated. Univariate and multivariate overall survival (OS) calculations were performed. Results Of 330 consecutive patients with synchronous metastases, 101 (30.6%) achieved an R0/1 status including 12 (11.9%) patients with multiple metastatic sites. Complex procedures were necessary in 45 (44.6%) patients. Five‐year OS was 53.0% for the R0/1 patient group. Multivariate analysis could not detect factors associated with prognosis. Conclusions With modern treatment, the prognosis of patients with synchronous CRC metastases can be improved. Decisions made by a MDT offered one‐third of patients a potentially curative approach to their stage IV disease. Despite the treatment of a high rate of patients with complex metastases necessitating complex procedures, we achieved a favorable 5‐year OS rate.

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“…However, it is unclear how overall survival is affected in patients who had resection of liver and lung metastases compared to those undergoing removal of isolated lung or liver metastases. 3, 18 We also did not have access to data granular enough to describe the exact location of primary tumors, and this has previously been shown to have an effect on rates and patterns of distant metastases and subsequent survival. 19, 20 However, we have no reason to suspect that the location of a primary tumor would be different based on insurance status, so this should not have substantially affected our result.…”

Section: Discussionmentioning

confidence: 99%

Insurance Status and Hospital Payer Mix Are Linked With Variation in Metastatic Site Resection in Patients With Advanced Colorectal Cancers

Healy

Pradarelli

Krell

et al. 2016

Diseases of the Colon &Amp; Rectum

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Background Despite substantially improved survival with metastatic site resection in colorectal cancers, uptake of aggressive surgical approaches remains low among certain patients. It is unknown whether financial determinants of care, such as insurance status, play a role in this treatment gap. Objective We sought to evaluate the effect of insurance status on metastasectomy in patients with advanced colorectal cancers. Methods Using the National Cancer Data Base Participant User File, incident cases of colorectal cancer metastatic to the lung and/or liver with diagnosis from 2010 – 2013, were identified. Controlling for patient, tumor, and hospital characteristics, hierarchical regression was used to examine associations between hospital payer mix and metastatic site resection. Results We identified 42,300 patients in our cohort with mean age 64 years. Metastatic site resection occurred in 12.3% of all patients. Adjusting for patient and hospital fixed effects, we found that patients who were uninsured or on Medicaid were 38% less likely to undergo metastasectomy (OR, 0.62; 95% CI, 0.56 – 0.66). Patients in hospitals treating a high percentage of uninsured or Medicaid patients were less likely to undergo metastasectomy, even after controlling for individual patient insurance status. Limitations The study was limited by its retrospective design and the granularity and accuracy of the National Cancer Data Base. Conclusion Differences in insurance status and hospital payer mix are associated with differences in rates of metastatic site resection in patients with colorectal cancer that is metastatic to the lung and/or liver. There is a need for improved access to metastatic site resection for individual patients who are uninsured or who have Medicaid insurance, and for all patients who seek care at hospitals treating a large proportion of uninsured or Medicaid patients. Remedies for individual patients could include improved access to private insurance through employment or individual plans or improved reimbursement from Medicaid for this procedure. Strategies for patients at low-performing hospitals include selective referral to centers that perform mestastectomy more frequently when appropriate.

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Surgical management of patients with colorectal cancer and simultaneous liver and lung metastases

Abstract: Patients who had resection of liver and lung metastases had similar overall survival to those who had undergone removal of isolated liver metastases.

Cited by 98 publications

References 39 publications

Therapy of primary and metastatic liver cancer by human iPS cell‐derived myeloid cells producing interferon‐β

Therapy of primary and metastatic liver cancer by human iPS cell‐derived myeloid cells producing interferon‐β

Prognosis in patients with synchronous colorectal cancer metastases after complete resection of the primary tumor and the metastases

Insurance Status and Hospital Payer Mix Are Linked With Variation in Metastatic Site Resection in Patients With Advanced Colorectal Cancers

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