Colorectal cancer with synchronous liver metastases: Does global management at the same centre improve results? - 01/02/13
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Summary |
Background |
Synchronous liver metastases (SLM) occur in 20% of colorectal cancers (CRC). Resection of SLM and CLC can be undertaken at different centres (separate management, SM) or at the same centre (global management, GM).
Methods |
Retrospective study of SLM and CRC resections carried out during 01/2000 – 12/2006 by SM or GM, using a combined or delayed strategy.
Results |
Morphologic characteristics and type of CRC and SLM resection were similar for the GM (n=45) or SM (n=66) groups. In patients with delayed liver resection (62 SM, 17 GM), chemotherapy prior to liver surgery was used in 92% and 38% of SM and GM patients (P<0.0001) and the median delay between procedures was 212 and 182 days, respectively (P=0.04). First step of liver resection was more often performed during colorectal surgery in the GM group (62 vs. 6% for SM, P<0.0001) and the mean number of procedures (CRC+SLM) was lower (1.6 vs. 2.3, P=0.003). Three-month mortality was 3% for GM and 0% for SM (n.s.). Overall survival rates were 67% and 51% for SM and GM at 3 years (n.s.), and 35 and 31% at 5 years (n.s.). Disease-free survival to 5 years was higher in SM patients (14% vs. 11%, P=0.009).
Conclusions |
GM of CRC and SLM was associated with fewer procedures but did not influence overall survival. SM was associated with a longer delay and increased use of chemotherapy between procedures, suggesting that more rigorous selection of SM patients for surgery may explain the higher disease-free survival after SLM resection.
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Vol 37 - N° 1
P. 56-63 - février 2013 Regresar al númeroBienvenido a EM-consulte, la referencia de los profesionales de la salud.
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