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Safety analysis of the oncological outcome after vein-preserving surgery for colorectal liver metastases detached from the main hepatic veins

(2015) LANGENBECKS ARCHIVES OF SURGERY. 400(6). p.683-691
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Abstract
Purpose: Recent studies have reported that margins alone do not predict survival in patients with a positive chemotherapy response. The aim of this retrospective study is to analyze the surgical and oncological outcomes of patients who underwent chemotherapy and liver resection for colorectal liver metastases (CRLM) with lesions detached from the main hepatic veins, comparing the vein-preserving (VP) approach with traditional surgery. Methods: Fourteen patients undergoing VP surgery from January 2006 to January 2013 were matched in a 1:2 ratio with a control group (CG) of 28 patients undergoing traditional resection. Results: The median follow-up was 43 months. The radiological response was classified as ‘partial response’ in eight VP patients and 11 controls (57 vs. 39 %, p = 0.249) and as ‘stable disease’ in three VP patients and 9 controls (21 vs. 32 %, p = 0.465). Ten VP (71.4 %) and twenty CG patients (71.4 %) experienced tumor relapse (p = 0.99). No venous edge recurrences were recorded in the VP group, whereas 1/13 (7.7 %) was observed in the control group (p = 0.99). The pathological response rate was 64 vs. 39 % (p = 0.037) in VP and CG patients, respectively. The 5-year recurrence-free survival rate was 24 % for VP patients and 25 % for CG patients (p = 0.431). Conclusion: In patients with a positive CT response, CRLM can be detached from the hepatic veins, as the oncological outcome is similar to that of a larger resection. The VP approach offers the possibility to enlarge the surgical indications, thus optimizing future surgical treatment chances.
Keywords
Surgical treatment of colorectal liver metastases, Parenchyma-sparing liver resection, Laparoscopic liver surgery, Chemotherapy and liver surgery, Chemotherapy and colorectal liver metastases, NEOADJUVANT CHEMOTHERAPY, PATHOLOGICAL RESPONSE, 2-STAGE HEPATECTOMY, SURGICAL RESECTION, MARGIN STATUS, CANCER, SURVIVAL, RECURRENCE, CARCINOMA, TRIAL

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MLA
Tomassini, Federico et al. “Safety Analysis of the Oncological Outcome After Vein-preserving Surgery for Colorectal Liver Metastases Detached from the Main Hepatic Veins.” LANGENBECKS ARCHIVES OF SURGERY 400.6 (2015): 683–691. Print.
APA
Tomassini, F., Bonadio, I., Smeets, P., De Paepe, K., Berardi, G., Ferdinande, L., Laurent, S., et al. (2015). Safety analysis of the oncological outcome after vein-preserving surgery for colorectal liver metastases detached from the main hepatic veins. LANGENBECKS ARCHIVES OF SURGERY, 400(6), 683–691.
Chicago author-date
Tomassini, Federico, Italo Bonadio, Peter Smeets, Karen De Paepe, Giammauro Berardi, Liesbeth Ferdinande, Stéphanie Laurent, Louis Libbrecht, Karen Geboes, and Roberto Troisi. 2015. “Safety Analysis of the Oncological Outcome After Vein-preserving Surgery for Colorectal Liver Metastases Detached from the Main Hepatic Veins.” Langenbecks Archives of Surgery 400 (6): 683–691.
Chicago author-date (all authors)
Tomassini, Federico, Italo Bonadio, Peter Smeets, Karen De Paepe, Giammauro Berardi, Liesbeth Ferdinande, Stéphanie Laurent, Louis Libbrecht, Karen Geboes, and Roberto Troisi. 2015. “Safety Analysis of the Oncological Outcome After Vein-preserving Surgery for Colorectal Liver Metastases Detached from the Main Hepatic Veins.” Langenbecks Archives of Surgery 400 (6): 683–691.
Vancouver
1.
Tomassini F, Bonadio I, Smeets P, De Paepe K, Berardi G, Ferdinande L, et al. Safety analysis of the oncological outcome after vein-preserving surgery for colorectal liver metastases detached from the main hepatic veins. LANGENBECKS ARCHIVES OF SURGERY. 2015;400(6):683–91.
IEEE
[1]
F. Tomassini et al., “Safety analysis of the oncological outcome after vein-preserving surgery for colorectal liver metastases detached from the main hepatic veins,” LANGENBECKS ARCHIVES OF SURGERY, vol. 400, no. 6, pp. 683–691, 2015.
@article{6932406,
  abstract     = {Purpose: Recent studies have reported that margins alone do not predict survival in patients with a positive chemotherapy response. The aim of this retrospective study is to analyze the surgical and oncological outcomes of patients who underwent chemotherapy and liver resection for colorectal liver metastases (CRLM) with lesions detached from the main hepatic veins, comparing the vein-preserving (VP) approach with traditional surgery.
Methods: Fourteen patients undergoing VP surgery from January 2006 to January 2013 were matched in a 1:2 ratio with a control group (CG) of 28 patients undergoing traditional resection.
Results: The median follow-up was 43 months. The radiological response was classified as ‘partial response’ in eight VP patients and 11 controls (57 vs. 39 %, p = 0.249) and as ‘stable disease’ in three VP patients and 9 controls (21 vs. 32 %, p = 0.465). Ten VP (71.4 %) and twenty CG patients (71.4 %) experienced tumor relapse (p = 0.99). No venous edge recurrences were recorded in the VP group, whereas 1/13 (7.7 %) was observed in the control group (p = 0.99). The pathological response rate was 64 vs. 39 % (p = 0.037) in VP and CG patients, respectively. The 5-year recurrence-free survival rate was 24 % for VP patients and 25 % for CG patients (p = 0.431).
Conclusion: In patients with a positive CT response, CRLM can be detached from the hepatic veins, as the oncological outcome is similar to that of a larger resection. The VP approach offers the possibility to enlarge the surgical indications, thus optimizing future surgical treatment chances.},
  author       = {Tomassini, Federico and Bonadio, Italo and Smeets, Peter and De Paepe, Karen and Berardi, Giammauro and Ferdinande, Liesbeth and Laurent, Stéphanie and Libbrecht, Louis and Geboes, Karen and Troisi, Roberto},
  issn         = {1435-2443},
  journal      = {LANGENBECKS ARCHIVES OF SURGERY},
  keywords     = {Surgical treatment of colorectal liver metastases,Parenchyma-sparing liver resection,Laparoscopic liver surgery,Chemotherapy and liver surgery,Chemotherapy and colorectal liver metastases,NEOADJUVANT CHEMOTHERAPY,PATHOLOGICAL RESPONSE,2-STAGE HEPATECTOMY,SURGICAL RESECTION,MARGIN STATUS,CANCER,SURVIVAL,RECURRENCE,CARCINOMA,TRIAL},
  language     = {eng},
  number       = {6},
  pages        = {683--691},
  title        = {Safety analysis of the oncological outcome after vein-preserving surgery for colorectal liver metastases detached from the main hepatic veins},
  url          = {http://dx.doi.org/10.1007/s00423-015-1332-9},
  volume       = {400},
  year         = {2015},
}

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