Survival and recurrence after neo-adjuvant chemotherapy and liver resection for colorectal metastases – A ten year study

Karanjia, N D; Lordan, Jeffrey T; Fawcett, William; Quiney, Nial; Worthington, Tim

doi:10.1016/j.ejso.2008.09.017

Cited by 53 publications

(53 citation statements)

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“…Those who underwent simultaneous liver resection and diaphragm excision were analysed separately.T he overall and disease-free survival of the entire consecutives eries were 46.1% and 27.9%, respectively (data not included here). 15 However,t hese survival Table 5 Univariate predictors of overall survival of liver resection for colorectal cancerm etastases (log ranking test)…”

Section: Earlya Nd Long-term Outcomes Of Liver Resection and Diaphragmentioning

confidence: 99%

Early and Long-Term Outcomes of Patients Undergoing Liver Resection and Diaphragm Excision for Advanced Colorectal Liver Metastases

Lordan

Riga

Worthington

et al. 2009

annals

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Ann RC oll Surg Engl 2009; 91:4 83-488 483Colorectal carcinoma is common in the Western world. 1,2 Approximately 50% of patients diagnosed with the disease develop liver metastases. 3,4 Currently,f or patients with colorectal liver metastases, liver resection offers the only potential chance for cure. However,t he proportion of patients with colorectal liver metastasese ligible for liver resection remains low (20-30%), 5,6 although there has been asteady increase over the past 10-15 years, [1][2][3][4] largely due to improvements in pre-operative assessment and selection and the use of neo-adjuvant chemotherapy.Studies have reported factors that influence early and long-term survival. 7-10Over the past 10 years in our unit, it was felt that diaphragm invasion and subsequent diaphragm excision at the time of liver resection predicted an adverse outcome. To the authors' knowledge there have not been any reports in the literature focusing on diaphragm excision with liver resection for colorectal liver metastases.Therefore, this study was undertaken to compare those patients who had liver resection and diaphragm excision with those who had liver resection alone, for colorectal liver metastases. Patients and MethodsAtotal of 285 consecutive completed liver resections for colorectal liver metastases in asingle unit over a10-year period (September 1996 to November 2006) were studied. Of these, 27 patients underwent liver resection and diaphragm excision simultaneously and 258 underwent liver resection At present, liver resection offers the best long-term outcome and only chance for cure in patients with colorectal liver metastases. However,t here are no large series that report the early and long-term outcomes of patients who require simultaneous diaphragm excision. This study was designed to investigate these patients.

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Section: Earlya Nd Long-term Outcomes Of Liver Resection and Diaphragmentioning

confidence: 99%

Early and Long-Term Outcomes of Patients Undergoing Liver Resection and Diaphragm Excision for Advanced Colorectal Liver Metastases

Lordan

Riga

Worthington

et al. 2009

annals

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“…As a regional hepatobiliary centre, our unit performs over 100 hepatic resections every year. We have been using thoracic epidural analgesia as a component of standard peri-operative care since 1996, with no significant epidural-related morbidity to date (haematoma, abscess, permanent neurological damage), and published outcome data amongst the best in the UK [2].…”

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Epidural anaesthesia and analgesia for liver resection

et al. 2014

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“…8 The treatment strategy is an individual approach combining adjuvant and neoadjuvant chemotherapy, surgery and ablation techniques. 1,8 accurate diagnosis of number, size and location of liver lesions is therefore vital. Especially in patients with cholestasis or cirrhosis, who may have limited functioning parenchyma.…”

Section: Discussionmentioning

confidence: 99%

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“…[1][2][3][4] To date, liver resection is the only modality that can offer potential longterm survival. [1][2][3][4] as such, accurate and precise assessment of liver metastases is vital to enable an appropriate surgical approach. 3,5,6 Historically, preoperative imaging (PoI) of the liver has been achieved by ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) with fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) being reserved to detect distant occult metastases.…”

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The value of intraoperative ultrasound and preoperative imaging, individually and in combination, in liver resection for metastatic colorectal cancer

Lordan

Stenson

Karanjia

2011

annals

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INTRODUCTION Liver resection is proved to offer potential long-term survival for colorectal liver metastases (CRLM). Accurate radiological assessment is vital to enable an appropriate surgical approach. The role of intraoperative ultrasound (IOUS) has been controversial. This study was designed to analyse the accuracy of IOUS compared with that of preoperative imaging (POI) in these patients. MATERIALS AND METHODS A prospective analysis of 51 consecutive patients who underwent liver resection for CRLM was undertaken. The accuracy of POI and IOUS were correlated and compared with histopathological analysis. Statistical analyses included t-tests, to compare continuous variables, and chi-square and Fisher's exact tests to compare categorical variables. p<0.05 was considered significant RESULTS POI correlated with histology in 35 patients (68.6%). The sensitivity and specificity were 82.4% and 86.3% respectively. IOUS correlated with histology in 31 (60.8%) patients. The sensitivity and specificity were 84.3% and 76.5% respectively. There was no difference in accuracy between modalities. The accuracy of POI combined with IOUS correlated with histology in 40 patients (78.4%). The sensitivity and specificity were 88.2% and 84.3% respectively. The accuracy of combined modalities was significantly greater than IOUS or POI alone. CONCLUSIONS POI combined with IOUS may significantly increase the diagnostic accuracy of patients undergoing liver resection for CRLM.

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Survival and recurrence after neo-adjuvant chemotherapy and liver resection for colorectal metastases – A ten year study

Cited by 53 publications

References 35 publications

Early and Long-Term Outcomes of Patients Undergoing Liver Resection and Diaphragm Excision for Advanced Colorectal Liver Metastases

Early and Long-Term Outcomes of Patients Undergoing Liver Resection and Diaphragm Excision for Advanced Colorectal Liver Metastases

Epidural anaesthesia and analgesia for liver resection

The value of intraoperative ultrasound and preoperative imaging, individually and in combination, in liver resection for metastatic colorectal cancer

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