1. Resectability and ablatability criteria for the treatment of liver only colorectal metastases:Multidisciplinary consensus document from the COLLISION trial group
- Author
-
Simeon J. S. Ruiter, Alette H. Ruarus, Warner Prevoo, Hester J. Scheffer, Ted Vink, Floris J. Rietema, Jan Jaap Janssen, Bart Geboers, Evelien A. C. Schouten, Bente van den Bemd, Robbert S. Puijk, Rutger-Jan Swijnenburg, Arjen Diederik, Francesco De Cobelli, G. Matthijs Kater, Gerie Groot, B.M. Zonderhuis, Fons H. Potters, C.J.A. Haasbeek, Gian Piero Serafino, Sanne Nieuwenhuizen, Mark J. Arntz, Florentine E. F. Timmer, Marleen C. A. M. Melenhorst, Maarten W Nijkamp, Anton F. Engelsman, Karin Nielsen, Kathelijn S. Versteeg, Colin Sietses, Hasan H. Eker, Marielle M.E. Coolsen, Koert P. de Jong, Petrousjka van den Tol, Mark C. Burgmans, Joris I. Erdmann, Wouter K. G. Leclercq, Cornelis H. C. Dejong, Christiaan van der Leij, A. Bruynzeel, Peter B. van den Boezem, Eric R. Manusama, Jurgen J. Fütterer, Jan J. J. de Vries, Luca Aldrighetti, Mark A.J. Meier, Johan W.H. Kruimer, Peter van Duijvendijk, Johannes H. W. de Wilt, Sarah Derks, Geert Kazemier, Bram B. van der Meijs, Martijn R. Meijerink, Surgery, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, CCA - Cancer Treatment and Quality of Life, Radiology and nuclear medicine, Radiation Oncology, Medical oncology, Amsterdam Gastroenterology Endocrinology Metabolism, CCA - Cancer Treatment and quality of life, AGEM - Re-generation and cancer of the digestive system, Nieuwenhuizen, S., Puijk, R. S., van den Bemd, B., Aldrighetti, L., Arntz, M., van den Boezem, P. B., Bruynzeel, A. M. E., Burgmans, M. C., de Cobelli, F., Coolsen, M. M. E., Dejong, C. H. C., Derks, S., Diederik, A., van Duijvendijk, P., Eker, H. H., Engelsman, A. F., Erdmann, J. I., Futterer, J. J., Geboers, B., Groot, G., Haasbeek, C. J. A., Janssen, J. -J., de Jong, K. P., Matthijs Kater, G., Kazemier, G., Kruimer, J. W. H., Leclercq, W. K. G., van der Leij, C., Manusama, E. R., Meier, M. A. J., van der Meijs, B. B., Melenhorst, M. C. A. M., Nielsen, K., Nijkamp, M. W., Potters, F. H., Prevoo, W., Rietema, F. J., Ruarus, A. H., Ruiter, S. J. S., Schouten, E. A. C., Serafino, G. P., Sietses, C., Swijnenburg, R. -J., Timmer, F. E. F., Versteeg, K. S., Vink, T., de Vries, J. J. J., de Wilt, J. H. W., Zonderhuis, B. M., Scheffer, H. J., van den Tol, P. M. P., Meijerink, M. R., Guided Treatment in Optimal Selected Cancer Patients (GUTS), Groningen Institute for Organ Transplantation (GIOT), MUMC+: MA Heelkunde (9), RS: NUTRIM - R2 - Liver and digestive health, and MUMC+: DA BV Medisch Specialisten Radiologie (9)
- Subjects
0301 basic medicine ,Cancer Research ,Partial hepatectomy ,Stereotactic body radiotherapy ,Radiofrequency ablation ,Colorectal cancer ,Ablatability criteria ,Resectability criteria ,ablatability criteria ,Systemic therapy ,law.invention ,Microwave ablation ,Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] ,NEOADJUVANT CHEMOTHERAPY ,0302 clinical medicine ,law ,Irreversible electroporation ,Medicine ,Stage (cooking) ,ELDERLY-PATIENTS ,Consensus guideline ,SURGICAL RESECTION ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,CANCER ,colorectal liver metastases ,Oncology ,stereotactic body radiotherapy ,Urological cancers Radboud Institute for Health Sciences [Radboudumc 15] ,030220 oncology & carcinogenesis ,PHASE-II ,radiofrequency ablation ,consensus guideline ,resectability criteria ,medicine.medical_specialty ,HEPATIC RESECTION ,lcsh:RC254-282 ,Article ,03 medical and health sciences ,thermal ablation ,All institutes and research themes of the Radboud University Medical Center ,irreversible electroporation ,business.industry ,General surgery ,Other Research Radboud Institute for Health Sciences [Radboudumc 0] ,Gold standard ,Cancer ,medicine.disease ,Thermal ablation ,partial hepatectomy ,Colorectal liver metastases ,Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10] ,030104 developmental biology ,microwave ablation ,business - Abstract
The guidelines for metastatic colorectal cancer crudely state that the best local treatment should be selected from a &lsquo, toolbox&rsquo, of techniques according to patient- and treatment-related factors. We created an interdisciplinary, consensus-based algorithm with specific resectability and ablatability criteria for the treatment of colorectal liver metastases (CRLM). To pursue consensus, members of the multidisciplinary COLLISION and COLDFIRE trial expert panel employed the RAND appropriateness method (RAM). Statements regarding patient, disease, tumor and treatment characteristics were categorized as appropriate, equipoise or inappropriate. Patients with ECOG&le, 2, ASA&le, 3 and Charlson comorbidity index &le, 8 should be considered fit for curative-intent local therapy. When easily resectable and/or ablatable (stage IVa), (neo)adjuvant systemic therapy is not indicated. When requiring major hepatectomy (stage IVb), neo-adjuvant systemic therapy is appropriate for early metachronous disease and to reduce procedural risk. To downstage patients (stage IVc), downsizing induction systemic therapy and/or future remnant augmentation is advised. Disease can only be deemed permanently unsuitable for local therapy if downstaging failed (stage IVd). Liver resection remains the gold standard. Thermal ablation is reserved for unresectable CRLM, deep-seated resectable CRLM and can be considered when patients are in poor health. Irreversible electroporation and stereotactic body radiotherapy can be considered for unresectable perihilar and perivascular CRLM 0-5cm. This consensus document provides per-patient and per-tumor resectability and ablatability criteria for the treatment of CRLM. These criteria are intended to aid tumor board discussions, improve consistency when designing prospective trials and advance intersociety communications. Areas where consensus is lacking warrant future comparative studies.
- Published
- 2020