Back to Search
Start Over
Curative-intent treatment of recurrent colorectal liver metastases: A comparison between ablation and resection.
- Source :
-
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2017 Oct; Vol. 43 (10), pp. 1901-1907. Date of Electronic Publication: 2017 Aug 26. - Publication Year :
- 2017
-
Abstract
- Background: Liver-limited recurrence after resection of colorectal liver metastases is a frequent occurrence, and can in some cases be treated with curative intent. Although surgical re-resection remains standard of care, there is growing interest in the role of ablation in this setting. The aim of this study was to compare the outcomes after curative-intent ablation and resection in patients with recurrent colorectal liver metastases.<br />Methods: We retrospectively analysed data from 366 consecutive patients who underwent liver resection for colorectal liver metastases between June 2010 and August 2015. Sixty-four developed liver-limited recurrence which was treated with curative intent, thirty-three (51.6%) by ablation and 31 (48.4%) by repeat resection.<br />Results: Patient groups were well matched, with surgically resected patients showing higher pre-operative carcinoembryonic antigen levels and larger metastases. There were fewer post-operative complications and shorter length of stay in the ablation group (p < 0.02). After a median follow-up of 36.2 months, median overall survival was the same for both the resected and ablated groups at 33.3 months. Median progression-free survival was longer for patients treated with surgery (10.2 months) compared to ablation (4.3 months) (p = 0.002).<br />Conclusions: Ablation or resection for liver-limited recurrence after surgery for colorectal liver metastases is associated with improved overall survival compared with systemic chemotherapy alone, and should always be considered for patients with resectable liver recurrence. Although ablation seemed to be associated with a shorter progression-free survival, post-procedure morbidity was significantly lower. The choice between ablation and resection should therefore be made on a personalised basis.<br /> (Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Colorectal Neoplasms mortality
Female
Follow-Up Studies
Humans
Incidence
Liver Neoplasms diagnosis
Liver Neoplasms secondary
Magnetic Resonance Imaging
Male
Middle Aged
Neoplasm Metastasis
Neoplasm Recurrence, Local epidemiology
Prognosis
Retrospective Studies
Survival Rate trends
Time Factors
Tomography, X-Ray Computed
United Kingdom epidemiology
Ablation Techniques methods
Colorectal Neoplasms pathology
Hepatectomy methods
Liver Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1532-2157
- Volume :
- 43
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 28888801
- Full Text :
- https://doi.org/10.1016/j.ejso.2017.08.008