Clinical outcomes for patients with liver-limited metastatic colorectal cancer: Arguing the case for specialist hepatobiliary multidisciplinary assessment
Abstract In patients with liver-limited metastatic colorectal cancer, hepatic resection can offer a significant survival benefit over systemic therapy alone. Specialist hepatobiliary multidisciplinary meetings are currently believed to provide the best forum to discuss the management for these patie...
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Veröffentlicht in: | European journal of surgical oncology 2016-09, Vol.42 (9), p.1331-1336 |
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creator | Thillai, Kiruthikah, MBBS MRCP Bsc Repana, Dimitra, MBBS Korantzis, Ippokratis, MBBS Kane, Pauline, MBBS MRCP FRCR Prachalias, Andreas, MBBS, MD Ross, Paul, MBBS MRCP PhD |
description | Abstract In patients with liver-limited metastatic colorectal cancer, hepatic resection can offer a significant survival benefit over systemic therapy alone. Specialist hepatobiliary multidisciplinary meetings are currently believed to provide the best forum to discuss the management for these patients. A retrospective analysis was undertaken of patients diagnosed with liver-limited metastatic colorectal cancer over 6 months within a cancer network in the United Kingdom. In addition, patients who were diagnosed but not referred to the hepatobiliary meeting were discussed within a virtual multi-disciplinary setting. Contributors were blinded and proposed management recorded. 159 newly diagnosed patients with liver-limited metastatic colorectal cancer were identified. 68 (43%) were referred at initial diagnosis and 38 (24%) referred following systemic treatment. 35 (51%) who were discussed at baseline underwent a subsequent hepatectomy or radio frequency ablation, as did 18 (47%) patients referred after chemotherapy. Of the remaining 53 (33%) patients not referred, imaging was available for 31 (58%). Decisions regarding potential liver-directed therapy were discussed within a multi-disciplinary setting. 13 (41.9%) were identified as resectable or potentially resectable and 11 (35.5%) may have been suitable for a clinical trial. In reality, none of these 31 patients (100%) underwent surgery or ablation. Whilst the majority of patients with liver-limited metastatic colorectal cancer were referred appropriately, this study demonstrates that a significant number with potentially resectable disease are not being discussed at specialist meetings. A review of all diagnosed cases would ensure that an increased number of patients are offered hepatic resection or ablation. |
doi_str_mv | 10.1016/j.ejso.2016.03.031 |
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Specialist hepatobiliary multidisciplinary meetings are currently believed to provide the best forum to discuss the management for these patients. A retrospective analysis was undertaken of patients diagnosed with liver-limited metastatic colorectal cancer over 6 months within a cancer network in the United Kingdom. In addition, patients who were diagnosed but not referred to the hepatobiliary meeting were discussed within a virtual multi-disciplinary setting. Contributors were blinded and proposed management recorded. 159 newly diagnosed patients with liver-limited metastatic colorectal cancer were identified. 68 (43%) were referred at initial diagnosis and 38 (24%) referred following systemic treatment. 35 (51%) who were discussed at baseline underwent a subsequent hepatectomy or radio frequency ablation, as did 18 (47%) patients referred after chemotherapy. Of the remaining 53 (33%) patients not referred, imaging was available for 31 (58%). Decisions regarding potential liver-directed therapy were discussed within a multi-disciplinary setting. 13 (41.9%) were identified as resectable or potentially resectable and 11 (35.5%) may have been suitable for a clinical trial. In reality, none of these 31 patients (100%) underwent surgery or ablation. Whilst the majority of patients with liver-limited metastatic colorectal cancer were referred appropriately, this study demonstrates that a significant number with potentially resectable disease are not being discussed at specialist meetings. A review of all diagnosed cases would ensure that an increased number of patients are offered hepatic resection or ablation.</description><identifier>ISSN: 0748-7983</identifier><identifier>EISSN: 1532-2157</identifier><identifier>DOI: 10.1016/j.ejso.2016.03.031</identifier><identifier>PMID: 27174600</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Catheter Ablation - methods ; Clinical Decision-Making ; Colorectal cancer ; Colorectal Neoplasms - pathology ; Female ; Gastroenterologists ; Hematology, Oncology and Palliative Medicine ; Hepatectomy ; Hepatectomy - methods ; Hepatobiliary ; Humans ; Liver metastases ; Liver Neoplasms - secondary ; Liver Neoplasms - surgery ; Male ; Metastasectomy - methods ; Middle Aged ; Multi-disciplinary meeting ; Oncologists ; Patient Care Team - organization & administration ; Radiologists ; Referral and Consultation ; Retrospective Studies ; Specialization ; Surgeons ; Surgery ; United Kingdom</subject><ispartof>European journal of surgical oncology, 2016-09, Vol.42 (9), p.1331-1336</ispartof><rights>2016 Elsevier Ltd</rights><rights>Copyright © 2016 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-a4d3344a4d41c4f0232c913adb107c826dd9257bbb4f038d72eee25da53cd7fe3</citedby><cites>FETCH-LOGICAL-c455t-a4d3344a4d41c4f0232c913adb107c826dd9257bbb4f038d72eee25da53cd7fe3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ejso.2016.03.031$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27174600$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Thillai, Kiruthikah, MBBS MRCP Bsc</creatorcontrib><creatorcontrib>Repana, Dimitra, MBBS</creatorcontrib><creatorcontrib>Korantzis, Ippokratis, MBBS</creatorcontrib><creatorcontrib>Kane, Pauline, MBBS MRCP FRCR</creatorcontrib><creatorcontrib>Prachalias, Andreas, MBBS, MD</creatorcontrib><creatorcontrib>Ross, Paul, MBBS MRCP PhD</creatorcontrib><title>Clinical outcomes for patients with liver-limited metastatic colorectal cancer: Arguing the case for specialist hepatobiliary multidisciplinary assessment</title><title>European journal of surgical oncology</title><addtitle>Eur J Surg Oncol</addtitle><description>Abstract In patients with liver-limited metastatic colorectal cancer, hepatic resection can offer a significant survival benefit over systemic therapy alone. Specialist hepatobiliary multidisciplinary meetings are currently believed to provide the best forum to discuss the management for these patients. A retrospective analysis was undertaken of patients diagnosed with liver-limited metastatic colorectal cancer over 6 months within a cancer network in the United Kingdom. In addition, patients who were diagnosed but not referred to the hepatobiliary meeting were discussed within a virtual multi-disciplinary setting. Contributors were blinded and proposed management recorded. 159 newly diagnosed patients with liver-limited metastatic colorectal cancer were identified. 68 (43%) were referred at initial diagnosis and 38 (24%) referred following systemic treatment. 35 (51%) who were discussed at baseline underwent a subsequent hepatectomy or radio frequency ablation, as did 18 (47%) patients referred after chemotherapy. Of the remaining 53 (33%) patients not referred, imaging was available for 31 (58%). Decisions regarding potential liver-directed therapy were discussed within a multi-disciplinary setting. 13 (41.9%) were identified as resectable or potentially resectable and 11 (35.5%) may have been suitable for a clinical trial. In reality, none of these 31 patients (100%) underwent surgery or ablation. Whilst the majority of patients with liver-limited metastatic colorectal cancer were referred appropriately, this study demonstrates that a significant number with potentially resectable disease are not being discussed at specialist meetings. A review of all diagnosed cases would ensure that an increased number of patients are offered hepatic resection or ablation.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Catheter Ablation - methods</subject><subject>Clinical Decision-Making</subject><subject>Colorectal cancer</subject><subject>Colorectal Neoplasms - pathology</subject><subject>Female</subject><subject>Gastroenterologists</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Hepatectomy</subject><subject>Hepatectomy - methods</subject><subject>Hepatobiliary</subject><subject>Humans</subject><subject>Liver metastases</subject><subject>Liver Neoplasms - secondary</subject><subject>Liver Neoplasms - surgery</subject><subject>Male</subject><subject>Metastasectomy - methods</subject><subject>Middle Aged</subject><subject>Multi-disciplinary meeting</subject><subject>Oncologists</subject><subject>Patient Care Team - organization & administration</subject><subject>Radiologists</subject><subject>Referral and Consultation</subject><subject>Retrospective Studies</subject><subject>Specialization</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>United Kingdom</subject><issn>0748-7983</issn><issn>1532-2157</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UsuKFTEQbURxrqM_4EKydNPXvPolIgwXXzDgQgV3IZ1Uz02b7rSp9Mj8il9r2nt14UIoqFA556RSp4riKaN7Rln9YtzDiGHP83lPRQ52r9ixSvCSs6q5X-xoI9uy6VpxUTxCHCmlnWi6h8UFb1gja0p3xc-Dd7Mz2pOwJhMmQDKESBadHMwJyQ-XjsS7W4ild5NLYMkESWPKAENM8CGCSZlu9GwgviRX8WZ18w1JR8g1hN9yuIBx2jtM5AhZO_TOOx3vyLT65KxD45bcx1bRiIA45ccfFw8G7RGenPNl8eXtm8-H9-X1x3cfDlfXpZFVlUotrRBS5iSZkQPlgpuOCW17RhvT8trajldN3_f5UrS24QDAK6srYWwzgLgsnp90lxi-r4BJTbkh8F7PEFZUrGWylhXlLEP5CWpiQIwwqCW6KbetGFWbJ2pUmydq80RRkWMjPTvrr_0E9i_ljwkZ8OoEgPzLWwdR5XlAHqd123CVDe7_-q__oZuzp9_gDnAMa5zz_BRTyBVVn7at2JaC1YJS2X0VvwCtGbeW</recordid><startdate>20160901</startdate><enddate>20160901</enddate><creator>Thillai, Kiruthikah, MBBS MRCP Bsc</creator><creator>Repana, Dimitra, MBBS</creator><creator>Korantzis, Ippokratis, MBBS</creator><creator>Kane, Pauline, MBBS MRCP FRCR</creator><creator>Prachalias, Andreas, MBBS, MD</creator><creator>Ross, Paul, MBBS MRCP PhD</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20160901</creationdate><title>Clinical outcomes for patients with liver-limited metastatic colorectal cancer: Arguing the case for specialist hepatobiliary multidisciplinary assessment</title><author>Thillai, Kiruthikah, MBBS MRCP Bsc ; Repana, Dimitra, MBBS ; Korantzis, Ippokratis, MBBS ; Kane, Pauline, MBBS MRCP FRCR ; Prachalias, Andreas, MBBS, MD ; Ross, Paul, MBBS MRCP PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-a4d3344a4d41c4f0232c913adb107c826dd9257bbb4f038d72eee25da53cd7fe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Catheter Ablation - methods</topic><topic>Clinical Decision-Making</topic><topic>Colorectal cancer</topic><topic>Colorectal Neoplasms - pathology</topic><topic>Female</topic><topic>Gastroenterologists</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Hepatectomy</topic><topic>Hepatectomy - methods</topic><topic>Hepatobiliary</topic><topic>Humans</topic><topic>Liver metastases</topic><topic>Liver Neoplasms - secondary</topic><topic>Liver Neoplasms - surgery</topic><topic>Male</topic><topic>Metastasectomy - methods</topic><topic>Middle Aged</topic><topic>Multi-disciplinary meeting</topic><topic>Oncologists</topic><topic>Patient Care Team - organization & administration</topic><topic>Radiologists</topic><topic>Referral and Consultation</topic><topic>Retrospective Studies</topic><topic>Specialization</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>United Kingdom</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Thillai, Kiruthikah, MBBS MRCP Bsc</creatorcontrib><creatorcontrib>Repana, Dimitra, MBBS</creatorcontrib><creatorcontrib>Korantzis, Ippokratis, MBBS</creatorcontrib><creatorcontrib>Kane, Pauline, MBBS MRCP FRCR</creatorcontrib><creatorcontrib>Prachalias, Andreas, MBBS, MD</creatorcontrib><creatorcontrib>Ross, Paul, MBBS MRCP PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Thillai, Kiruthikah, MBBS MRCP Bsc</au><au>Repana, Dimitra, MBBS</au><au>Korantzis, Ippokratis, MBBS</au><au>Kane, Pauline, MBBS MRCP FRCR</au><au>Prachalias, Andreas, MBBS, MD</au><au>Ross, Paul, MBBS MRCP PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical outcomes for patients with liver-limited metastatic colorectal cancer: Arguing the case for specialist hepatobiliary multidisciplinary assessment</atitle><jtitle>European journal of surgical oncology</jtitle><addtitle>Eur J Surg Oncol</addtitle><date>2016-09-01</date><risdate>2016</risdate><volume>42</volume><issue>9</issue><spage>1331</spage><epage>1336</epage><pages>1331-1336</pages><issn>0748-7983</issn><eissn>1532-2157</eissn><abstract>Abstract In patients with liver-limited metastatic colorectal cancer, hepatic resection can offer a significant survival benefit over systemic therapy alone. Specialist hepatobiliary multidisciplinary meetings are currently believed to provide the best forum to discuss the management for these patients. A retrospective analysis was undertaken of patients diagnosed with liver-limited metastatic colorectal cancer over 6 months within a cancer network in the United Kingdom. In addition, patients who were diagnosed but not referred to the hepatobiliary meeting were discussed within a virtual multi-disciplinary setting. Contributors were blinded and proposed management recorded. 159 newly diagnosed patients with liver-limited metastatic colorectal cancer were identified. 68 (43%) were referred at initial diagnosis and 38 (24%) referred following systemic treatment. 35 (51%) who were discussed at baseline underwent a subsequent hepatectomy or radio frequency ablation, as did 18 (47%) patients referred after chemotherapy. Of the remaining 53 (33%) patients not referred, imaging was available for 31 (58%). Decisions regarding potential liver-directed therapy were discussed within a multi-disciplinary setting. 13 (41.9%) were identified as resectable or potentially resectable and 11 (35.5%) may have been suitable for a clinical trial. In reality, none of these 31 patients (100%) underwent surgery or ablation. Whilst the majority of patients with liver-limited metastatic colorectal cancer were referred appropriately, this study demonstrates that a significant number with potentially resectable disease are not being discussed at specialist meetings. A review of all diagnosed cases would ensure that an increased number of patients are offered hepatic resection or ablation.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>27174600</pmid><doi>10.1016/j.ejso.2016.03.031</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adult Aged Aged, 80 and over Catheter Ablation - methods Clinical Decision-Making Colorectal cancer Colorectal Neoplasms - pathology Female Gastroenterologists Hematology, Oncology and Palliative Medicine Hepatectomy Hepatectomy - methods Hepatobiliary Humans Liver metastases Liver Neoplasms - secondary Liver Neoplasms - surgery Male Metastasectomy - methods Middle Aged Multi-disciplinary meeting Oncologists Patient Care Team - organization & administration Radiologists Referral and Consultation Retrospective Studies Specialization Surgeons Surgery United Kingdom |
title | Clinical outcomes for patients with liver-limited metastatic colorectal cancer: Arguing the case for specialist hepatobiliary multidisciplinary assessment |
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