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Curative-intent treatment of recurrent colorectal liver metastases: A comparison between ablation and resection.

Curative-intent treatment of recurrent colorectal liver metastases: A comparison between ablation and resection.

Authors :
Diaz-Nieto, Rafael
Fenwick, Stephen W.
Poston, Graeme J.
Malik, Hassan Z.
Dupré, Aurélien
Jones, Robert P.
Source :
European Journal of Surgical Oncology; Oct2017, Vol. 43 Issue 10, p1901-1907, 7p
Publication Year :
2017

Abstract

Background Liver-limited recurrence after resection of colorectal liver metastases is a frequent occurrence, and can in some cases be treated with curative intent. Although surgical re-resection remains standard of care, there is growing interest in the role of ablation in this setting. The aim of this study was to compare the outcomes after curative-intent ablation and resection in patients with recurrent colorectal liver metastases. Methods We retrospectively analysed data from 366 consecutive patients who underwent liver resection for colorectal liver metastases between June 2010 and August 2015. Sixty-four developed liver-limited recurrence which was treated with curative intent, thirty-three (51.6%) by ablation and 31 (48.4%) by repeat resection. Results Patient groups were well matched, with surgically resected patients showing higher pre-operative carcinoembryonic antigen levels and larger metastases. There were fewer post-operative complications and shorter length of stay in the ablation group (p < 0.02). After a median follow-up of 36.2 months, median overall survival was the same for both the resected and ablated groups at 33.3 months. Median progression-free survival was longer for patients treated with surgery (10.2 months) compared to ablation (4.3 months) (p = 0.002). Conclusions Ablation or resection for liver-limited recurrence after surgery for colorectal liver metastases is associated with improved overall survival compared with systemic chemotherapy alone, and should always be considered for patients with resectable liver recurrence. Although ablation seemed to be associated with a shorter progression-free survival, post-procedure morbidity was significantly lower. The choice between ablation and resection should therefore be made on a personalised basis. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
07487983
Volume :
43
Issue :
10
Database :
Supplemental Index
Journal :
European Journal of Surgical Oncology
Publication Type :
Academic Journal
Accession number :
125468449
Full Text :
https://doi.org/10.1016/j.ejso.2017.08.008