Shankar, A; Leonard, P; Renaut, AJ; Lederman, J; Lees, WR; Gillams, AR; ... Taylor, I; + view all Shankar, A; Leonard, P; Renaut, AJ; Lederman, J; Lees, WR; Gillams, AR; Harrison, E; Taylor, I; - view fewer (2001) Neo-adjuvant therapy improves resectability rates for colorectal liver metastases. ANN ROY COLL SURG , 83 (2) 85 - 88.
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Purpose: Liver resection improves survival in selected patients with colorectal Liver metastases. However, the majority of patients with colorectal liver metastases have inoperable disease at presentation. Neo-adjuvant therapy (systemic or regional chemotherapy and interstitial laser therapy) used singly or in combination may convert a selected group of patients with irresectable liver metastases into an operable state.Patients and Methods: We report a series of patients with initially inoperable multiple colorectal liver metastases who became operable after neo-adjuvant therapy. Operability was defined as unilateral disease limited to the liver. Twelve patients (7 female, 5 male, median age 57 years, range 38-69 years) with multiple inoperable colorectal liver metastases (8 synchronous, 4 metachronous) were initially treated with systemic chemotherapy (n = 7), hepatic arterial chemotherapy (n = 2) and chemotherapy plus interstitial laser therapy (n = 3).Results: In all cases, a significant response was achieved which enabled subsequent liver resection to be undertaken. There was only one postoperative complication (8%) and no peri-operative deaths. 3 patients were operated on within the last 12 months and are still alive. Of the remainder, 1 died within 1 year with recurrent disease. The remaining patients have a median survival of 2.5 years, range 1.39-4 years.Conclusions: These results are similar to those reported for patients undergoing resection for operable metastases without neo-adjuvant therapy. Aggressive multimodality treatment of colorectal liver metastases in specialised centres may improve the resectability rates and survival in a selected group of patients.
|Title:||Neo-adjuvant therapy improves resectability rates for colorectal liver metastases|
|Keywords:||neo-adjuvant, colorectal, liver metastases, resection, RANDOMIZED TRIAL, RESECTION, CANCER, CHEMOTHERAPY, FLOXURIDINE|
|UCL classification:||UCL > School of Life and Medical Sciences > Faculty of Medical Sciences > Surgery and Interventional Science (Division of) > Research Department of General Surgery|
UCL > School of Life and Medical Sciences > Faculty of Medical Sciences > UCL Medical School
UCL > School of Life and Medical Sciences > Faculty of Medical Sciences > Wolfson Institute and Cancer Institute Administration > Cancer Institute > CRUK Cancer Trials Centre
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