Radical surgery in the management of initially unresectable liver metastases from colorectal cancer in the era of bio-chemotherapy

S S11 Exclusive I.O.R.T. for early stage breast cancer: Results after 93 cases using GEC-ESTRO criteria G. Gambula*, M. Dessena, B. Demontis, L.P. Grosso, S. Porru, M. Dess i, M. Fiorbelli, G. Lay, G. Murenu 1 Oncology Hospital UOC Experimental Surgery, Cagliari, Italy Oncology Hospital UOC Health Physics, Cagliari, Italy Oncology Hospital UOC Oncologic Radiotherapy, Cagliari, Italy * Corresponding author: Giuseppe Gambula, Oncology Hospital UOC Experimental Surgery, Cagliari, Italy. E-mail address: gambul75@yahoo.it (G. Gambula) Study objectives: To evaluate feasibility, tolerability, cosmetic outcome and local control of intra-operative radiation therapy (IORT) as an exclusive treatment of early stage breast cancer in patients selected according to GEC-ESTRO criteria (good candidates). Materials and methods: From October 2008 to December 2013, 93 patients underwent wide breast cancer excision or quadrantectomy followed by IORT on tumor bed with accelerated electrons (Novac 7 NRT) at the dose of 21Gy. Patients were aging at least 50 years with unicentric, unifocal, pT1-2 ( 5) associated to occurrence of major morbidity after the first-step were predictive factors of second-step failure. Major hepatectomy with the need of transfusion in pts who received more than 8 cycles of (bio)chemotherapy were associated to significant postoperative morbidity. The overall mortality rate after liver resection was 9%. The overall 3eyear survival rate in pts who underwent complete radical liver surgery were 65% versus 0% for those who could not undergo radical surgery. Conclusion: The results suggest that in highly selected pts with initially not easily resectable LM from CRC, radical (one or two-step) hepatectomy can increase the 3-year survival rate after down-sizing biochemotherapy with consequent mortality. http://dx.doi.org/10.1016/j.ejso.2014.10.031 Long-term follow up in patients with IPMN-branch duct type (BDT) not submitted to surgery S. Molfino*, G.L. Baiocchi, N. Portolani, M. Bartoli, D. Lomiento, G. Merigo, S.M. Giulini Surgical Clinic, University of Brescia, Brescia, Italy * Corresponding author: Sarah Molfino, Brescia, Italy. E-mail address: sarahmolfino@gmail.com (S. Molfino) Study objective: Even if International Guidelines contemplate surgery for IPMN-BDT larger than 3 cm of diameter, with wall-thickness >3 mm, with parietal nodules, however some data suggest that a lot of these tumors could only be followed-up. The aim of this article is to analyze the implications of long-term follow-up in patients with IPMN-BDT not submitted to surgery, with particular attention on clinical and morphological evolution. Material and methods: During the period 2006e2011, two-hundred and thirty-four patients with IPMN have been observed. Surgery was directed to patients with IPMN MDT and BDT + MDT (92 patients) and to other 13 patients with IPMN-BDT with a strong suspect of malignancy (by cytology with EUS and/or 18FDG-PET), independently from Sendai Criteria.