Journal ArticleDOI
Long-term outcomes of radiofrequency ablation combined with hepatectomy compared with hepatectomy alone for colorectal liver metastases
Katsunori Imai,Katsunori Imai,Katsunori Imai,Marc-Antoine Allard,Marc-Antoine Allard,Marc-Antoine Allard,C. Castro Benitez,C. Castro Benitez,C. Castro Benitez,Eric Vibert,Eric Vibert,Eric Vibert,A. Sa Cunha,A. Sa Cunha,A. Sa Cunha,Daniel Cherqui,Daniel Cherqui,Daniel Cherqui,D. Castaing,D. Castaing,D. Castaing,Hideo Baba,René Adam,René Adam,René Adam +24 more
TLDR
Combining radiofrequency ablation with hepatectomy may enable treatment with curative intent for patients with colorectal liver metastasis (CRLM), but the oncological outcomes in comparison with resection alone remain to be clarified.Abstract:
Background
Combining radiofrequency ablation (RFA) with hepatectomy may enable treatment with curative intent for patients with colorectal liver metastasis (CRLM). However, the oncological outcomes in comparison with resection alone remain to be clarified.
Methods
Patients who underwent a first hepatectomy between 2001 and 2012 for CRLM were enrolled. Short- and long-term outcomes of patients who underwent hepatectomy plus RFA were compared with those of patients who had hepatectomy alone using propensity score matching.
Results
Of a total of 553 patients, hepatectomy + RFA and hepatectomy alone were performed in 37 and 516 respectively. Before matching, patients in the hepatectomy + RFA group were characterized primarily by a larger tumour burden. After matching of 31 patients who underwent hepatectomy + RFA with 93 who had hepatectomy alone, background characteristics were well balanced. In the matched cohort, overall and disease-free survival in the hepatectomy + RFA group were no different from those among patients who had hepatectomy alone (5-year overall survival rate 57 versus 61 per cent, P = 0·649; 5-year disease-free survival rate 19 versus 17 per cent, P = 0·865). Local recurrence at the ablated site was observed in four of 31 patients (13 per cent). Although overall local recurrence (ablated site and/or cut surface) was more frequent in the hepatectomy + RFA group (9 of 31 (29 per cent) versus 11 of 93 (12 per cent); P = 0·032), there was no difference in intrahepatic disease-free survival between the two groups (P = 0·705).
Conclusion
Hepatectomy + RFA achieved outcomes comparable to hepatectomy alone. Combining RFA with hepatectomy should be considered as an option to achieve cure.read more
Citations
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Journal ArticleDOI
Radiofrequency and Microwave Ablation Compared to Systemic Chemotherapy and to Partial Hepatectomy in the Treatment of Colorectal Liver Metastases: A Systematic Review and Meta-Analysis
Martijn R. Meijerink,Robbert S. Puijk,Aukje A. J. M. van Tilborg,Kirsten Holdt Henningsen,Llenalia Garcia Fernandez,Mattias Neyt,Juanita Heymans,Jacqueline S. Frankema,Koert P. de Jong,Dick J. Richel,Warner Prevoo,Joan Vlayen +11 more
TL;DR: The results from the EORTC-CLOCC trial, the comparable survival for ablation + PH versus PH alone, the potential to induce long-term disease control and the low complication rate argue in favour of ablation over chemotherapy alone.
Journal ArticleDOI
Hepatic metastasis from colorectal cancer
TL;DR: From predominantly palliative as the primary aim, a comprehensive multidisciplinary approach is now the mainstay of treatment with very successful outcomes and the new paradigm in the treatment of metastatic CRC has dawned.
Journal ArticleDOI
Multidisciplinary approach of liver metastases from colorectal cancer.
TL;DR: It is recommended that all patients with CRLM be managed by a multidisciplinary approach (MDA) to select the best strategy and new treatment procedures may contribute to improve prognosis; hence, the necessity for MDA for the treatment of CRLm will further increase.
Journal ArticleDOI
Prospective phase II trial of combination hepatic artery infusion and systemic chemotherapy for unresectable colorectal liver metastases: Long term results and curative potential.
Linda M. Pak,Nancy E. Kemeny,Marinela Capanu,Joanne F. Chou,Taryn M. Boucher,Andrea Cercek,Vinod P. Balachandran,T. Peter Kingham,Peter J. Allen,Ronald P. DeMatteo,William R. Jarnagin,Michael I. D’Angelica +11 more
TL;DR: This study represents an update of long‐term survival and conversion to resectability in patients with unresectable CRLM treated with HAI and SYS chemotherapy in a phase II study.
Journal ArticleDOI
Curative-intent treatment of recurrent colorectal liver metastases: A comparison between ablation and resection
Aurélien Dupré,Robert P. Jones,Rafael Diaz-Nieto,Stephen W. Fenwick,Graeme J. Poston,Hassan Malik +5 more
TL;DR: Although ablation seemed to be associated with a shorter progression-free survival, post-procedure morbidity was significantly lower and the choice between ablation and resection should always be considered for patients with resectable liver recurrence.
References
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Journal ArticleDOI
Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey.
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Journal ArticleDOI
Recurrence and Outcomes Following Hepatic Resection, Radiofrequency Ablation, and Combined Resection/Ablation for Colorectal Liver Metastases
Eddie K. Abdalla,Jean Nicolas Vauthey,Lee M. Ellis,Vickie Ellis,Raphael E. Pollock,Kristine Broglio,Kenneth R. Hess,Steven A. Curley +7 more
TL;DR: Hepatic resection is the treatment of choice for colorectal liver metastases and RFA alone or in combination with resection for unresectable patients does not provide survival comparable to resection, and provides survival only slightly superior to nonsurgical treatment.
Journal ArticleDOI
Rescue surgery for unresectable colorectal liver metastases downstaged by chemotherapy: a model to predict long-term survival.
René Adam,Valérie Delvart,Gérard Pascal,Adrian Valeanu,Denis Castaing,Daniel Azoulay,Sylvie Giacchetti,Bernard Paule,Francis Kunstlinger,Odile Ghémard,Francis Lévi,Henri Bismuth +11 more
TL;DR: Modern chemotherapy allows 12.5% of patients with unresectable CRLM to be rescued by liver surgery, with a wide use of repeat hepatectomies and extrahepatic resections, and four preoperative risk factors could select the patients most likely to benefit from this strategy.
Journal ArticleDOI
Surgical resection of hepatic metastases from colorectal cancer: a systematic review of published studies.
TL;DR: It is clear that there is group of patients with liver metastases who may become long-term disease- free survivors following hepatic resection, and whether the addition of adjuvant treatments results in improved survival is needed.
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