The "reversed" treatment approach for synchronous liver metastases and colorectal cancer. Feasability and first results

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State: Public
Version: After imprimatur
Serval ID
serval:BIB_8A55AE92A708
Type
A Master's thesis.
Publication sub-type
Master (thesis) (master)
Collection
Publications
Institution
Title
The "reversed" treatment approach for synchronous liver metastases and colorectal cancer. Feasability and first results
Author(s)
Céline Du Pasquier
Director(s)
Prof. Nicolas Demartines 
Codirector(s)
Prof. Markus Schäfer 
Institution details
Université de Lausanne, Faculté de biologie et médecine
Publication state
Accepted
Issued date
2011
Language
english
Number of pages
25
Abstract
Background: The « reversed treatment» approach inverts the treatment sequence of¦advanced synchronous colorectal liver metastases - i.e. the liver metastasis is¦treated first, followed by resection of the primary tumor. Chemotherapy is performed¦before and after liver surgery. We recently started to use a reversed treatment¦approach in selected patients. The aim of this study is to critically assess this new¦treatment modality.¦Methods: Nine patients (7 male, 2 female, mean age 62 years) benefited from this¦new treatment between November 2008 and May 2010. The data were collected¦retrospectively.¦Results: All patients responded to the neoadjuvant chemotherapy. The median¦number of liver metastases was 6 (range 1 - 22). The median size of the largest liver¦metastases was 4.3 cm (range 2.6 - 13 cm). Three patients had portal vein¦embolization prior to liver surgery. Two patients could not complete the treatment.¦One had to undergo emergency surgery for occluding colonic tumor. The second one¦showed liver recurrence before starting the adjuvant chemotherapy. The seven¦patients who completed the treatment are still alive after a median time of 27 months¦(range 17 - 37 months). Seven of them had recurrence (1 rectal, 6 liver). The median¦disease-free survival was 9 months (range 0 - 17 months).¦Conclusion: Based on our preliminary experiences, the reversed strategy shows¦encouraging results for the treatment of advanced synchronous colorectal liver¦metastases in well selected patients. The treatment was generally well tolerated and¦long term survival seems to be prolonged.
Keywords
Colorectal cancer, synchronous, liver metastases, reversed treatment, liver-first approach
Create date
14/05/2012 13:38
Last modification date
20/08/2019 14:49
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