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International Journal of Colorectal Disease

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Open Access 01-10-2012 | Original Article

Bilobar spreading of colorectal liver metastases does not significantly affect survival after R0 resection in the era of interdisciplinary multimodal treatment

Authors: K. Homayounfar, A. Bleckmann, L. C. Conradi, T. Sprenger, T. Beissbarth, T. Lorf, M. Niessner, C. O. Sahlmann, J. Meller, H. Becker, T. Liersch, B. M. Ghadimi

Published in: International Journal of Colorectal Disease | Issue 10/2012

Abstract

Purpose

Bilobar colorectal liver metastases (CRLM) are often considered incurable or associated with poor prognosis even after R0 resection. In this single-center study, we evaluate the impact of CRLM spreading on recurrence-free survival (RFS) and cancer-specific overall survival (CSS) after R0 resection of CRLM with respect to multimodal treatment strategies including perioperative chemotherapy and multistep resections.

Methods

Between January 2001 and December 2010, R0 resection could be achieved in 70 patients with bilobar and 100 with unilobar CRLM. Extent of disease, perioperative chemotherapy, surgical procedures, adjuvant treatment, histopathological workup, RFS, and CSS were compared between both cohorts.

Results

Forty-six (66 %) patients with bilobar and 26 (26 %) patients with unilobar CRLM received preoperative chemotherapy (p < 0.001). For bilobar CRLM, more extended and multistep resection including portal vein occlusion were performed (29 % versus 3 %; p < 0.001). Morbidity (39 % versus 28 %, p = 0.183) and mortality (1 % versus 3 %, p = 0.644) rates were comparable in both patients’ cohorts. Postoperative therapy was applied in adjuvant intent to 42 (60 %) versus 51 (51 %) patients (p = 0.275). The 5-year RFS and CSS rates were 24 % versus 31 % (p = 0.169) and 42 % versus 55 % (p = 0.131), respectively.

Conclusions

To our single-center experience, there is no significant effect of CRLM spreading (bilobar versus unilobar) on RFS and CSS rates. Bilobar CRLM are more likely to require extended multimodal efforts to achieve R0 resection.

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Title: Bilobar spreading of colorectal liver metastases does not significantly affect survival after R0 resection in the era of interdisciplinary multimodal treatment
Authors: K. Homayounfar
A. Bleckmann
L. C. Conradi
T. Sprenger
T. Beissbarth
T. Lorf
M. Niessner
C. O. Sahlmann
J. Meller
H. Becker
T. Liersch
B. M. Ghadimi
Publication date: 01-10-2012
Publisher: Springer-Verlag
Published in: International Journal of Colorectal Disease / Issue 10/2012
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-012-1455-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Bilobar spreading of colorectal liver metastases does not significantly affect survival after R0 resection in the era of interdisciplinary multimodal treatment

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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