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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 8/2016

01-08-2016 | Hepatobiliary Tumors

Survival Following Resection of Intra- and Extra-Hepatic Metastases from Colorectal Cancer: A Phase II Trial

Authors: Alice C. Wei, MD, MSc, FRSCS, FACS, Natalie G. Coburn, MD, MPH, FACS, Katharine S. Devitt, MSc, Pablo E. Serrano, MD, MPH, MSc, Carol-Anne Moulton, MBBS, MEd, PhD, FRACS, Sean P. Cleary, MD, MSc, FRCSC, Calvin Law, MD, MPH, FRCSC, Malcolm J. Moore, MD, FRCPC, Steven Gallinger, MD, MSc, FRCSC

Published in: Annals of Surgical Oncology | Issue 8/2016

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Abstract

Purpose

Metastasectomy for intrahepatic metastases (IHM) from colorectal cancer (CRC) provides excellent 5-year overall survival (OS). Presence of extrahepatic metastases (EHM) has been a historic contraindication to surgery. Due to improved safety of hepatectomy, there is growing interest in multisite metastasectomy for IHM and EHM. The objective of this study was to evaluate the results of metastasectomy for patients with IHM and EHM from CRC.

Methods

A phase II study of metastasectomy for both IHM and EHM from CRC. Eligible patients with any number of IHM and up to three EHM foci, resectable with RO intent, were offered metastasectomy. Clinical, survival, and quality of life (QoL) data were analyzed using standard statistical methods.

Results

Twenty-six patients were enrolled with a median age of 58 (range 32–84) years; 14/26 (54 %) presented with synchronous disease. The lung was the most common EHM site (13/26, 50 %). Protocol surgery was completed in 20/26 (77 %), including 12/26 (46 %) planned sequential resections. Major morbidity and perioperative mortality were 5/26 (19 %) and 1/26 (4 %), respectively. The QoL decline appeared to be transient. All QoL domains returned to baseline by 1-year posttreatment. The median recurrence-free survival (RFS) was 5 months by intent-to-treat analysis. The median OS from the time of CRC diagnosis and metastasectomy were 50 and 38 months (3-year OS 80 and 53 %), respectively.

Conclusions

Complete metastasectomy of multisite CRC is safe, but disease recurs in the majority of patients. Data suggest that aggressive multisite metastasectomy may provide OS benefit for selected patients.
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Metadata
Title
Survival Following Resection of Intra- and Extra-Hepatic Metastases from Colorectal Cancer: A Phase II Trial
Authors
Alice C. Wei, MD, MSc, FRSCS, FACS
Natalie G. Coburn, MD, MPH, FACS
Katharine S. Devitt, MSc
Pablo E. Serrano, MD, MPH, MSc
Carol-Anne Moulton, MBBS, MEd, PhD, FRACS
Sean P. Cleary, MD, MSc, FRCSC
Calvin Law, MD, MPH, FRCSC
Malcolm J. Moore, MD, FRCPC
Steven Gallinger, MD, MSc, FRCSC
Publication date
01-08-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 8/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5189-0

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