The treatment of patients with colorectal liver metastases at the department of abdominal surgery in the general hospital Marribor
Abstract
Background: Liver resection, in collaboration with new diagnostic tools and chemotherapeutic agents, is the only potentially curative therapy for colorectal liver metastases (CRLM).
Methods: In the period from January 1, 1996 to December 31, 2004, 94 patients with CRLM were treated in our departement. Liver resection was possible for 84 patients. 110 procedures were performed in these patients.
Results: At the end of the study (December 31, 2005), 22 patients were alive with no evidence of disease, 20 patients were alive with disease and 42 patients died of disease. The median follow-up for surviving patients was 33.8 months (from 13 to 123). The overall 5-year survival rate of the whole group of patients (R0 and R1 resections together) was 38 % with median survival 29.3 months. The overall 5-year survival of patients with R0 resection was 42 % with median survival of 32.3 months. The overall 5-year survival of patients with R1 resection was 29 % with median survival of 25.7 months. The postoperative complication rate was 23.8 % mortality was 2.3 %.
Conclusions: Providing that decisions regarding the therapeutic approach are carried out in a multidisciplinary manner in specialized centers in collaboration with surgeons, oncologists and radiologists, we can offer a cure to some patients with CRLM.
Downloads
References
Incidenca raka v Sloveniji 2003. Ljubljana: Onkološki inštitut – Register raka za Slovenijo; 2006.
Ivanecz A, Koželj M, Krebs B, Gajzer B, Brvar M, Kavalar R. Operacijsko zdravljenje raka debelega črevesa in danke na oddelku za abdominalno kirurgijo Splošne bolnišnice Maribor leta 2000. Zdrav Vestn 2003; 72 Suppl I: 61–4.
Fusai G, Davidson BR. Strategies to increase the resectability of liver metastases from colorectal cancer. Dig Surg 2003; 20: 481– 96.
Scheele J, Stang R, Altendorf-Hofmann A, Paul M. Resection of colorectal liver metastases. World J Surg 1995; 19: 59–71.
Jaeck D, Bachellier P, Guiguet M, Boudjema K, Vaillant JC, Balladur P, et al. Long-term survival following resection of colorectal hepatic metastases. Association Francaise de Chirurgie. Br J Surg 1997; 84: 977–80.
Adam R, Avisar E, Ariche A, Giachetti S, Azoulay D, Bismuth F, et al. Five-year survival following hepatic resection after neo-adjuvant therapy for nonresectable colorectal liver metastases. Ann Surg Oncol 2001; 8: 347–53.
Minagawa M, Makuuchi M, Torzilli G, Takayama T, Kawasaki S, Kosuge T, et al. Extension of the fronteries of surgical indications in the treatment of liver metastases from colorectal cancer: long-term results. Ann Surg 2000; 231: 487–99.
Fong Y, Fortner J, Sun RL, Brennan MF, Blumgart LH. Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer. Analysis of 1001 consecutive cases. Ann Surg 1999; 230: 309–21.
Nordlinger B, Guiget M, Vaillant JC, Balladur P, Boudjema K, Bachelier P, et al. Surgical resection of colorectal carcinoma metastases to the liver: a prognostic scoring system to improve case selection. Cancer 1996; 771: 1254–62.
Elias D, Ouellet JF, de Baere T, Lasser P, Roche A. Preoperative selective portal vein embolization before hepatectomy for liver metastases: Long-term results and impact on survival. Surgery 2002; 131: 294–9.
Bilchik AJ, Wood TF, Allegra D, Tsioulias GJ, Chung M, Rose DM, et al. Cryosurgical ablation and radiofrequency ablation for unresectable hepatic malignant neoplasms: A proposed algorithm. Arch Surg 2000; 135: 657–62.
Aoki T, Sugawara Y, Imamura H, Seyama Y, Minagawa M, Makuuchi M, et al. Hepatic resection with reconstruction of the inferior vena cava or hepatic venous confluence for metastatic liver tumor from colorectal cancer. J Am Coll Surg 2004; 198: 366–72.
Ivanecz A, Potrč S, Horvat M, Gadžijev EM. Kirurško zdravljenje jetrnih zasevkov raka debelega črevesa in danke na oddelku za Abdominalno kirurgijo Splošne bolnišnice Maribor. In: Zbornik predavanj IV. kongresa Združenja kirurgov Slovenije 2006. Nova Gorica: Grafitisk Tomačevica; 2006. p. 74–6.
The Author transfers to the Publisher (Zdravniški vestnik/Slovenian Medical Journal) all economic copyrights following form Article 22 of the Slovene Copyright and Related Rights Act (ZASP), including the right of reproduction, the right of distribution, the rental right, the right of public performance, the right of public transmission, the right of public communication by means of phonograms and videograms, the right of public presentation, the right of broadcasting, the right of rebroadcasting, the right of secondary broadcasting, the right of communication to the public, the right of transformation, the right of audiovisual adaptation and all other rights of the author according to ZASP.
The aforementioned rights are transferred non-exclusively, for an unlimited number of editions, for the term of the statutory
The Author can make use of his work himself or transfer subjective rights to others only after 3 months from date of first publishing in the journal Zdravniški vestnik/Slovenian Medical Journal.
The Publisher (Zdravniški vestnik/Slovenian Medical Journal) has the right to transfer the rights, acquired parties without explicit consent of the Author.
The Author consents that the Article be published under the Creative Commons BY-NC 4.0 (attribution-non-commercial) or comparable licence.
