Treatment strategy for synchronous metastases of colorectal cancer: is hepatic resection after an observation interval appropriate?

Abstract

The outcome was similarly favorable in cases of synchronous hepatic metastasis and in cases of metachronous metastasis. Delaying resection allows accurate understanding of the number and location of hepatic metastases, and is beneficial in determining candidates for surgery and in selecting surgical procedure.

Validity of observation interval for synchronous hepatic metastases of colorectal cancer: changes in hepatic and extrahepatic metastatic foci

“…Tumor diameter and number of metastases were tested for significance with the t test, and surgical procedure and recurrence in remnant liver were tested for significance with the chi-squared test After hepatic resection, recurrence was seen in the remnant liver in 44 (26.8%) cases, and the 3-and 5-year cumulative survival rates were 71.9% and 51.8%, respectively. The posthepatectomy outcome in cases of synchronous hepatic metastasis was similarly favorable with that in metachronous metastasis [1]. Our treatment outcomes were much better than those in reports of other authors [4][5][6][7][8].…”

“…The basic policy at our hospital for colorectal cancer with synchronous hepatic metastasis has been to resect the primary colorectal cancer, followed if necessary by resection of the hepatic metastasis after an observation interval of 3 months. We have reported that the posthepatectomy outcome in our cases of synchronous hepatic metastasis was similarly favorable with that in metachronous metastasis [1]. In the present study, we investigated the changes in hepatic and extrahepatic metastatic foci during the observation interval and indicated the validity of observation interval for synchronous hepatic metastases.…”

“…2), but the mean diameter of liver metastases was about five times larger in the interval resection patients than in the synchronous resection patients. Considering that the sole independent prognostic factor after liver resection for colorectal cancer metastases was the tumor diameter of the liver metastases [1], the treatment outcome with interval resection would seem to be favorable.…”

“…Our basic policy has been to wait for an interval of 3 months after resection of the primary lesion and then to conduct hepatic resection for the synchronous hepatic metastases [1]. We have already reported that, between January 1983 and December 2003, 164 patients who had no extrahepatic metastases or recurrences underwent resection for hepatic metastases of colorectal cancer.…”

A case of clinical complete response of colorectal liver metastasis following chemotherapy with S-1 and oxaliplatin (SOX) in combination with bevacizumab

“…CRC patients with synchronous liver metastases are known to have a poorer prognosis than patients with metachronous liver metastases 7,8) . The potential occult liver metastasis is pointed out in patients with synchronous liver metastases and it was reported that new metastatic lesions may appear in these patients during three months after the resection of primary colonic tumor 9) . In the present case, a solitary liver metastasis was found preoperatively, and postoperative treatment with SOX plus BV was successfully performed.…”