Synchronous liver resection with cytoreductive surgery for the treatment of liver and peritoneal metastases from colon cancer: results from an Australian centre
Background Treatment of peritoneal metastases (PM) and liver metastases (LM) from colon cancer remains controversial. LM has been viewed as exclusion criterion for cytoreductive surgery (CRS) on the basis that such spread represents systemic disease. CRS and intraperitoneal chemotherapy (IPC) has ga...
Gespeichert in:
| Veröffentlicht in: | ANZ journal of surgery 2017-11, Vol.87 (11), p.E167-E172 |
|---|---|
| Hauptverfasser: | , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | E172 |
|---|---|
| container_issue | 11 |
| container_start_page | E167 |
| container_title | ANZ journal of surgery |
| container_volume | 87 |
| creator | Alzahrani, Nayef Ung, Lawson Valle, Sarah J. Liauw, Winston Morris, David L. |
| description | Background
Treatment of peritoneal metastases (PM) and liver metastases (LM) from colon cancer remains controversial. LM has been viewed as exclusion criterion for cytoreductive surgery (CRS) on the basis that such spread represents systemic disease. CRS and intraperitoneal chemotherapy (IPC) has gained increasing recognition as a treatment modality for selected patients with colon cancer and PM. This study analyses results of CRS and IPC for colon cancer and synchronous resection for treatment of LM and PM.
Methods
Seventy‐eight patients with PM/LM colon cancer were analysed. Forty‐two patients with PM were treated for disease limited to the peritoneum (A), and 36 patients received treatment for both PM and LM (B). Overall survival (OS), disease‐free survival (DFS), morbidity, mortality and recurrence were compared.
Results
Median OS and DFS was 32.8 and 13.5 months. The median OS for A and B were 45.5 and 24.4 months respectively. Within B patients, 18 had a peritoneal carcinomatosis index (PCI) >7 and >3 LM and median survival of 21.8 months compared with 18 patients with PCI ≤7 and LM ≤3 with median survival of 38.4 months. Median DFS for A and B were 17.7 and 8.5 months respectively. Twenty‐seven in total experienced major complications following surgery. Sixty‐one patients recurred. Of A, 71.4% recurred compared with B at 86.1%.
Conclusion
While our study is limited, it has demonstrated encouraging evidence that long‐term survival outcomes can be achieved in this small but significant number of patients treated by CRS/IPC and additional synchronous liver resection with no significant increase in morbidity when compared with CRS/IPC alone. |
| doi_str_mv | 10.1111/ans.13231 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1826638608</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1826638608</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3531-37cfea98e4429fa6fecfc4fde6bdb629347318312284e8275cd4a855c96adc3c3</originalsourceid><addsrcrecordid>eNp1kctu1DAUhi0EoqWw4AWQJTZlMW18TcJuVHGTKlgU1pbHOWZSOfZw7LTK2_CouExggYRlyUf258-Xn5CXrLlgtV3amC-Y4II9IqdMSrXhrG8frzWTQpyQZznfNg3TuldPyQnXrO0E607Jz5sluj2mmOZMw3gHSBEyuDKmSO_HsqduKQlhmOvUHdA843fAhfqEtOyBFgRbJoiFJr_ut3GgB8CxpAg20AmKzbVDph7TRF0KVe1sdIBvHw6bQ1mXbKTbORe0Yaylq1aE5-SJtyHDi3U8I9_ev_t69XFz_eXDp6vt9cYJJdhGtM6D7TuQkvfeag_OO-kH0Lthp3kvZFvfKxjnnYSOt8oN0nZKuV7bwQknzsj50XvA9GOGXMw0Zgch2Aj1bwzruNai001X0df_oLdpxlhvZ1ivet60iqlKvTlSDlPOCN4ccJwsLoY15iE2U2Mzv2Or7KvVOO8mGP6Sf3KqwOURuB8DLP83me3nm6PyF1INpaQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1959207515</pqid></control><display><type>article</type><title>Synchronous liver resection with cytoreductive surgery for the treatment of liver and peritoneal metastases from colon cancer: results from an Australian centre</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Alzahrani, Nayef ; Ung, Lawson ; Valle, Sarah J. ; Liauw, Winston ; Morris, David L.</creator><creatorcontrib>Alzahrani, Nayef ; Ung, Lawson ; Valle, Sarah J. ; Liauw, Winston ; Morris, David L.</creatorcontrib><description>Background
Treatment of peritoneal metastases (PM) and liver metastases (LM) from colon cancer remains controversial. LM has been viewed as exclusion criterion for cytoreductive surgery (CRS) on the basis that such spread represents systemic disease. CRS and intraperitoneal chemotherapy (IPC) has gained increasing recognition as a treatment modality for selected patients with colon cancer and PM. This study analyses results of CRS and IPC for colon cancer and synchronous resection for treatment of LM and PM.
Methods
Seventy‐eight patients with PM/LM colon cancer were analysed. Forty‐two patients with PM were treated for disease limited to the peritoneum (A), and 36 patients received treatment for both PM and LM (B). Overall survival (OS), disease‐free survival (DFS), morbidity, mortality and recurrence were compared.
Results
Median OS and DFS was 32.8 and 13.5 months. The median OS for A and B were 45.5 and 24.4 months respectively. Within B patients, 18 had a peritoneal carcinomatosis index (PCI) >7 and >3 LM and median survival of 21.8 months compared with 18 patients with PCI ≤7 and LM ≤3 with median survival of 38.4 months. Median DFS for A and B were 17.7 and 8.5 months respectively. Twenty‐seven in total experienced major complications following surgery. Sixty‐one patients recurred. Of A, 71.4% recurred compared with B at 86.1%.
Conclusion
While our study is limited, it has demonstrated encouraging evidence that long‐term survival outcomes can be achieved in this small but significant number of patients treated by CRS/IPC and additional synchronous liver resection with no significant increase in morbidity when compared with CRS/IPC alone.</description><identifier>ISSN: 1445-1433</identifier><identifier>EISSN: 1445-2197</identifier><identifier>DOI: 10.1111/ans.13231</identifier><identifier>PMID: 26178318</identifier><language>eng</language><publisher>Australia: Blackwell Publishing Ltd</publisher><subject>Aged ; Australia - epidemiology ; Chemotherapy ; Colon cancer ; Colonic Neoplasms - mortality ; Colonic Neoplasms - surgery ; Colorectal cancer ; Colorectal surgery ; Combined Modality Therapy - methods ; Complications ; Cytoreduction Surgical Procedures - methods ; cytoreductive surgery ; Disease control ; Disease-Free Survival ; Female ; Gastric cancer ; Hepatectomy - methods ; Humans ; Hyperthermia, Induced - methods ; hyperthermic intraperitoneal chemotherapy (HIPEC) ; Liver ; Liver - pathology ; Liver - surgery ; liver metastasis ; Liver Neoplasms - drug therapy ; Liver Neoplasms - mortality ; Liver Neoplasms - secondary ; Liver Neoplasms - surgery ; Male ; Metastases ; Metastasis ; Middle Aged ; Morbidity ; Neoplasm Metastasis - drug therapy ; Neoplasm Recurrence, Local - surgery ; Patients ; PCI ; Perioperative Period - statistics & numerical data ; peritoneal metastasis ; Peritoneal Neoplasms - drug therapy ; Peritoneal Neoplasms - mortality ; Peritoneal Neoplasms - secondary ; Peritoneal Neoplasms - surgery ; Peritoneum ; Surgical outcomes ; Survival ; Survival Rate</subject><ispartof>ANZ journal of surgery, 2017-11, Vol.87 (11), p.E167-E172</ispartof><rights>2015 Royal Australasian College of Surgeons</rights><rights>2015 Royal Australasian College of Surgeons.</rights><rights>2017 Royal Australasian College of Surgeons</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3531-37cfea98e4429fa6fecfc4fde6bdb629347318312284e8275cd4a855c96adc3c3</citedby><cites>FETCH-LOGICAL-c3531-37cfea98e4429fa6fecfc4fde6bdb629347318312284e8275cd4a855c96adc3c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fans.13231$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fans.13231$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26178318$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Alzahrani, Nayef</creatorcontrib><creatorcontrib>Ung, Lawson</creatorcontrib><creatorcontrib>Valle, Sarah J.</creatorcontrib><creatorcontrib>Liauw, Winston</creatorcontrib><creatorcontrib>Morris, David L.</creatorcontrib><title>Synchronous liver resection with cytoreductive surgery for the treatment of liver and peritoneal metastases from colon cancer: results from an Australian centre</title><title>ANZ journal of surgery</title><addtitle>ANZ J Surg</addtitle><description>Background
Treatment of peritoneal metastases (PM) and liver metastases (LM) from colon cancer remains controversial. LM has been viewed as exclusion criterion for cytoreductive surgery (CRS) on the basis that such spread represents systemic disease. CRS and intraperitoneal chemotherapy (IPC) has gained increasing recognition as a treatment modality for selected patients with colon cancer and PM. This study analyses results of CRS and IPC for colon cancer and synchronous resection for treatment of LM and PM.
Methods
Seventy‐eight patients with PM/LM colon cancer were analysed. Forty‐two patients with PM were treated for disease limited to the peritoneum (A), and 36 patients received treatment for both PM and LM (B). Overall survival (OS), disease‐free survival (DFS), morbidity, mortality and recurrence were compared.
Results
Median OS and DFS was 32.8 and 13.5 months. The median OS for A and B were 45.5 and 24.4 months respectively. Within B patients, 18 had a peritoneal carcinomatosis index (PCI) >7 and >3 LM and median survival of 21.8 months compared with 18 patients with PCI ≤7 and LM ≤3 with median survival of 38.4 months. Median DFS for A and B were 17.7 and 8.5 months respectively. Twenty‐seven in total experienced major complications following surgery. Sixty‐one patients recurred. Of A, 71.4% recurred compared with B at 86.1%.
Conclusion
While our study is limited, it has demonstrated encouraging evidence that long‐term survival outcomes can be achieved in this small but significant number of patients treated by CRS/IPC and additional synchronous liver resection with no significant increase in morbidity when compared with CRS/IPC alone.</description><subject>Aged</subject><subject>Australia - epidemiology</subject><subject>Chemotherapy</subject><subject>Colon cancer</subject><subject>Colonic Neoplasms - mortality</subject><subject>Colonic Neoplasms - surgery</subject><subject>Colorectal cancer</subject><subject>Colorectal surgery</subject><subject>Combined Modality Therapy - methods</subject><subject>Complications</subject><subject>Cytoreduction Surgical Procedures - methods</subject><subject>cytoreductive surgery</subject><subject>Disease control</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Gastric cancer</subject><subject>Hepatectomy - methods</subject><subject>Humans</subject><subject>Hyperthermia, Induced - methods</subject><subject>hyperthermic intraperitoneal chemotherapy (HIPEC)</subject><subject>Liver</subject><subject>Liver - pathology</subject><subject>Liver - surgery</subject><subject>liver metastasis</subject><subject>Liver Neoplasms - drug therapy</subject><subject>Liver Neoplasms - mortality</subject><subject>Liver Neoplasms - secondary</subject><subject>Liver Neoplasms - surgery</subject><subject>Male</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Neoplasm Metastasis - drug therapy</subject><subject>Neoplasm Recurrence, Local - surgery</subject><subject>Patients</subject><subject>PCI</subject><subject>Perioperative Period - statistics & numerical data</subject><subject>peritoneal metastasis</subject><subject>Peritoneal Neoplasms - drug therapy</subject><subject>Peritoneal Neoplasms - mortality</subject><subject>Peritoneal Neoplasms - secondary</subject><subject>Peritoneal Neoplasms - surgery</subject><subject>Peritoneum</subject><subject>Surgical outcomes</subject><subject>Survival</subject><subject>Survival Rate</subject><issn>1445-1433</issn><issn>1445-2197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kctu1DAUhi0EoqWw4AWQJTZlMW18TcJuVHGTKlgU1pbHOWZSOfZw7LTK2_CouExggYRlyUf258-Xn5CXrLlgtV3amC-Y4II9IqdMSrXhrG8frzWTQpyQZznfNg3TuldPyQnXrO0E607Jz5sluj2mmOZMw3gHSBEyuDKmSO_HsqduKQlhmOvUHdA843fAhfqEtOyBFgRbJoiFJr_ut3GgB8CxpAg20AmKzbVDph7TRF0KVe1sdIBvHw6bQ1mXbKTbORe0Yaylq1aE5-SJtyHDi3U8I9_ev_t69XFz_eXDp6vt9cYJJdhGtM6D7TuQkvfeag_OO-kH0Lthp3kvZFvfKxjnnYSOt8oN0nZKuV7bwQknzsj50XvA9GOGXMw0Zgch2Aj1bwzruNai001X0df_oLdpxlhvZ1ivet60iqlKvTlSDlPOCN4ccJwsLoY15iE2U2Mzv2Or7KvVOO8mGP6Sf3KqwOURuB8DLP83me3nm6PyF1INpaQ</recordid><startdate>201711</startdate><enddate>201711</enddate><creator>Alzahrani, Nayef</creator><creator>Ung, Lawson</creator><creator>Valle, Sarah J.</creator><creator>Liauw, Winston</creator><creator>Morris, David L.</creator><general>Blackwell Publishing 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>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>201711</creationdate><title>Synchronous liver resection with cytoreductive surgery for the treatment of liver and peritoneal metastases from colon cancer: results from an Australian centre</title><author>Alzahrani, Nayef ; Ung, Lawson ; Valle, Sarah J. ; Liauw, Winston ; Morris, David L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3531-37cfea98e4429fa6fecfc4fde6bdb629347318312284e8275cd4a855c96adc3c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Australia - epidemiology</topic><topic>Chemotherapy</topic><topic>Colon cancer</topic><topic>Colonic Neoplasms - mortality</topic><topic>Colonic Neoplasms - surgery</topic><topic>Colorectal cancer</topic><topic>Colorectal surgery</topic><topic>Combined Modality Therapy - methods</topic><topic>Complications</topic><topic>Cytoreduction Surgical Procedures - methods</topic><topic>cytoreductive surgery</topic><topic>Disease control</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Gastric cancer</topic><topic>Hepatectomy - methods</topic><topic>Humans</topic><topic>Hyperthermia, Induced - methods</topic><topic>hyperthermic intraperitoneal chemotherapy (HIPEC)</topic><topic>Liver</topic><topic>Liver - pathology</topic><topic>Liver - surgery</topic><topic>liver metastasis</topic><topic>Liver Neoplasms - drug therapy</topic><topic>Liver Neoplasms - mortality</topic><topic>Liver Neoplasms - secondary</topic><topic>Liver Neoplasms - surgery</topic><topic>Male</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Neoplasm Metastasis - drug therapy</topic><topic>Neoplasm Recurrence, Local - surgery</topic><topic>Patients</topic><topic>PCI</topic><topic>Perioperative Period - statistics & numerical data</topic><topic>peritoneal metastasis</topic><topic>Peritoneal Neoplasms - drug therapy</topic><topic>Peritoneal Neoplasms - mortality</topic><topic>Peritoneal Neoplasms - secondary</topic><topic>Peritoneal Neoplasms - surgery</topic><topic>Peritoneum</topic><topic>Surgical outcomes</topic><topic>Survival</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Alzahrani, Nayef</creatorcontrib><creatorcontrib>Ung, Lawson</creatorcontrib><creatorcontrib>Valle, Sarah J.</creatorcontrib><creatorcontrib>Liauw, Winston</creatorcontrib><creatorcontrib>Morris, David L.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>ANZ journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Alzahrani, Nayef</au><au>Ung, Lawson</au><au>Valle, Sarah J.</au><au>Liauw, Winston</au><au>Morris, David L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Synchronous liver resection with cytoreductive surgery for the treatment of liver and peritoneal metastases from colon cancer: results from an Australian centre</atitle><jtitle>ANZ journal of surgery</jtitle><addtitle>ANZ J Surg</addtitle><date>2017-11</date><risdate>2017</risdate><volume>87</volume><issue>11</issue><spage>E167</spage><epage>E172</epage><pages>E167-E172</pages><issn>1445-1433</issn><eissn>1445-2197</eissn><abstract>Background
Treatment of peritoneal metastases (PM) and liver metastases (LM) from colon cancer remains controversial. LM has been viewed as exclusion criterion for cytoreductive surgery (CRS) on the basis that such spread represents systemic disease. CRS and intraperitoneal chemotherapy (IPC) has gained increasing recognition as a treatment modality for selected patients with colon cancer and PM. This study analyses results of CRS and IPC for colon cancer and synchronous resection for treatment of LM and PM.
Methods
Seventy‐eight patients with PM/LM colon cancer were analysed. Forty‐two patients with PM were treated for disease limited to the peritoneum (A), and 36 patients received treatment for both PM and LM (B). Overall survival (OS), disease‐free survival (DFS), morbidity, mortality and recurrence were compared.
Results
Median OS and DFS was 32.8 and 13.5 months. The median OS for A and B were 45.5 and 24.4 months respectively. Within B patients, 18 had a peritoneal carcinomatosis index (PCI) >7 and >3 LM and median survival of 21.8 months compared with 18 patients with PCI ≤7 and LM ≤3 with median survival of 38.4 months. Median DFS for A and B were 17.7 and 8.5 months respectively. Twenty‐seven in total experienced major complications following surgery. Sixty‐one patients recurred. Of A, 71.4% recurred compared with B at 86.1%.
Conclusion
While our study is limited, it has demonstrated encouraging evidence that long‐term survival outcomes can be achieved in this small but significant number of patients treated by CRS/IPC and additional synchronous liver resection with no significant increase in morbidity when compared with CRS/IPC alone.</abstract><cop>Australia</cop><pub>Blackwell Publishing Ltd</pub><pmid>26178318</pmid><doi>10.1111/ans.13231</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1445-1433 |
| ispartof | ANZ journal of surgery, 2017-11, Vol.87 (11), p.E167-E172 |
| issn | 1445-1433 1445-2197 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1826638608 |
| source | MEDLINE; Access via Wiley Online Library |
| subjects | Aged Australia - epidemiology Chemotherapy Colon cancer Colonic Neoplasms - mortality Colonic Neoplasms - surgery Colorectal cancer Colorectal surgery Combined Modality Therapy - methods Complications Cytoreduction Surgical Procedures - methods cytoreductive surgery Disease control Disease-Free Survival Female Gastric cancer Hepatectomy - methods Humans Hyperthermia, Induced - methods hyperthermic intraperitoneal chemotherapy (HIPEC) Liver Liver - pathology Liver - surgery liver metastasis Liver Neoplasms - drug therapy Liver Neoplasms - mortality Liver Neoplasms - secondary Liver Neoplasms - surgery Male Metastases Metastasis Middle Aged Morbidity Neoplasm Metastasis - drug therapy Neoplasm Recurrence, Local - surgery Patients PCI Perioperative Period - statistics & numerical data peritoneal metastasis Peritoneal Neoplasms - drug therapy Peritoneal Neoplasms - mortality Peritoneal Neoplasms - secondary Peritoneal Neoplasms - surgery Peritoneum Surgical outcomes Survival Survival Rate |
| title | Synchronous liver resection with cytoreductive surgery for the treatment of liver and peritoneal metastases from colon cancer: results from an Australian centre |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-19T10%3A53%3A46IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Synchronous%20liver%20resection%20with%20cytoreductive%20surgery%20for%20the%20treatment%20of%20liver%20and%20peritoneal%20metastases%20from%20colon%20cancer:%20results%20from%20an%20Australian%20centre&rft.jtitle=ANZ%20journal%20of%20surgery&rft.au=Alzahrani,%20Nayef&rft.date=2017-11&rft.volume=87&rft.issue=11&rft.spage=E167&rft.epage=E172&rft.pages=E167-E172&rft.issn=1445-1433&rft.eissn=1445-2197&rft_id=info:doi/10.1111/ans.13231&rft_dat=%3Cproquest_cross%3E1826638608%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1959207515&rft_id=info:pmid/26178318&rfr_iscdi=true |