Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 14, 2016; 22(6): 2126-2132
Published online Feb 14, 2016. doi: 10.3748/wjg.v22.i6.2126
Role of a liver-first approach for synchronous colorectal liver metastases
Kun Wang, Wei Liu, Xiao-Luan Yan, Bao-Cai Xing
Kun Wang, Wei Liu, Xiao-Luan Yan, Bao-Cai Xing, Hepatopancreatobiliary Surgery Department I, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing 100142, China
Author contributions: Wang K and Liu W contributed equally to this work; Wang K and Liu W designed and performed the research and wrote the paper; Xing BC designed the research and supervised the report; Liu W designed the research and contributed to the analysis; Yan XL provided clinical advice; Xing BC supervised the report.
Supported by the National Nature Science Foundation of China, No. 81371868.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Beijing Cancer Hospital.
Informed consent statement: All study participants or a legal guardian provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Bao-Cai Xing, MD, Professor, Hepatopancreatobiliary Surgery Department I, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University School of Oncology, Beijing Cancer Hospital and Institute, No. 52, Fu-Cheng-Lu Street, Beijing 100142, China. xingbaocai88@sina.com
Telephone: +86-10-88196045 Fax: + 86-10-88196567
Received: June 9, 2015
Peer-review started: June 11, 2015
First decision: August 26, 2015
Revised: September 11, 2015
Accepted: November 19, 2015
Article in press: November 19, 2015
Published online: February 14, 2016
Processing time: 228 Days and 3.7 Hours
Abstract

AIM: To evaluate the feasibility and survival outcomes of a liver-first approach.

METHODS: Between January 2009 and April 2013, 18 synchronous colorectal liver metastases (sCRLMs) patients with a planned liver-first approach in the Hepatopancreatobiliary Surgery Department I of the Beijing Cancer Hospital were enrolled in this study. Clinical data, surgical outcomes, morbidity and mortality rates were collected. The feasibility and long-term outcomes of the approach were retrospectively analyzed.

RESULTS: Sixteen patients (88.9%) completed the treatment protocol for primary and liver tumors. The main reason for treatment failure was liver disease recurrence. The 1 and 3 year overall survival rates were 94.4% and 44.8%, respectively. The median survival time was 30 mo. The postoperative morbidity and mortality were 22.2% and 0%, respectively, following a hepatic resection, and were 18.8% and 0%, respectively, after a colorectal surgery.

CONCLUSION: The liver-first approach appeared to be feasible and safe. It can be performed with a comparable mortality and morbidity to the traditional treatment paradigm. This approach might offer a curative opportunity for sCRLM patients with a high liver disease burden.

Keywords: Liver metastases; Resection; Colorectal cancer; Synchronous

Core tip: This is a retrospective study to investigate the feasibility and survival outcome of the liver-first approach for synchronous colorectal liver metastases. The postoperative morbidity and mortality were acceptable. The 1 and 3 year overall survival rates were 94.4% and 44.8%, respectively. The approach should be performed in patients with synchronous colorectal liver metastases with a high liver disease burden.