The "reversed" treatment approach for synchronous liver metastases and colorectal cancer. Feasability and first results

Détails

Ressource 1Télécharger: BIB_8A55AE92A708.P001.pdf (621.03 [Ko])
Etat: Serval
Version: Après imprimatur
ID Serval
serval:BIB_8A55AE92A708
Type
Mémoire
Sous-type
(Mémoire de) maîtrise (master)
Collection
Publications
Titre
The "reversed" treatment approach for synchronous liver metastases and colorectal cancer. Feasability and first results
Auteur(s)
Céline Du Pasquier
Directeur(s)
Prof. Nicolas Demartines 
Codirecteur(s)
Prof. Markus Schäfer 
Institution
Université de Lausanne, Faculté de biologie et médecine
Statut éditorial
Acceptée
Date de publication
2011
Langue
anglais
Nombre de pages
25
Résumé
Background: The « reversed treatment» approach inverts the treatment sequence of¦advanced synchronous colorectal liver metastases - i.e. the liver metastasis is¦treated first, followed by resection of the primary tumor. Chemotherapy is performed¦before and after liver surgery. We recently started to use a reversed treatment¦approach in selected patients. The aim of this study is to critically assess this new¦treatment modality.¦Methods: Nine patients (7 male, 2 female, mean age 62 years) benefited from this¦new treatment between November 2008 and May 2010. The data were collected¦retrospectively.¦Results: All patients responded to the neoadjuvant chemotherapy. The median¦number of liver metastases was 6 (range 1 - 22). The median size of the largest liver¦metastases was 4.3 cm (range 2.6 - 13 cm). Three patients had portal vein¦embolization prior to liver surgery. Two patients could not complete the treatment.¦One had to undergo emergency surgery for occluding colonic tumor. The second one¦showed liver recurrence before starting the adjuvant chemotherapy. The seven¦patients who completed the treatment are still alive after a median time of 27 months¦(range 17 - 37 months). Seven of them had recurrence (1 rectal, 6 liver). The median¦disease-free survival was 9 months (range 0 - 17 months).¦Conclusion: Based on our preliminary experiences, the reversed strategy shows¦encouraging results for the treatment of advanced synchronous colorectal liver¦metastases in well selected patients. The treatment was generally well tolerated and¦long term survival seems to be prolonged.
Mots-clé
Colorectal cancer, synchronous, liver metastases, reversed treatment, liver-first approach
Création de la notice
14/05/2012 14:38
Dernière modification de la notice
03/03/2018 19:09
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