Liver metastases from colorectal cancer. Different strategies and outcomes
Author
Summary, in English
Specific aims to investigate:
I. Why do patients scheduled for the liver-first strategy not complete both the planned liver and primary resections?
II. Compare the liver-first to the classical strategy for patients presenting with synchronous CRLM (sCRLM).
III. Compare the simultaneous strategy with the classical strategy for patients presenting with sCRLM, focusing on patients undergoing major liver resections.
IV. Measure liver regeneration and survival data after a repeated liver procedure (resection or ablation) for recurrent CRLM.
Results and conclusions:
I. Up to 35% of patients with sCRLM do not complete the planned treatment.
II. The liver-first and the classical strategy did not show any overall survival difference.
III. Simultaneous resections appeared to have more complications, shorter total length-of-stay but similar overall survival as patients chosen for the classical strategy.
IV. We found a small change in FLV after two hepatic procedures but with a considerable inter-individual variation. Patients selected for a repeated hepatic procedure for recurrent CRLM had an acceptable survival.
When choosing different strategies for sCRLM patients, our results imply that we should select according to treatment logistics, tumor symptoms, and surgical feasibility. When patients present with recurrent CRLM, a high variance in liver volume after repeated resection can be expected when planning future repeated resections.
Department/s
Publishing year
2019
Language
English
Publication/Series
Lund University, Faculty of Medicine Doctoral Dissertation Series
Volume
2019
Issue
122
Full text
Document type
Dissertation
Publisher
Lund University, Faculty of Medicine
Topic
- Surgery
Keywords
- Liver metastases
- Colorectal Neoplasms
- Hepatectomy
- Mortality
- Treatment outcome
- Retrospective studies
- Sweden
- Registries
- Volume measurements
- Repeat hepatectomy
- liver surgery
- Functional liver volume
- Repeated operation
- Recurrence
Status
Published
Supervisor
ISBN/ISSN/Other
- ISSN: 1652-8220
- ISBN: 978-91-7619-851-3
Defence date
13 December 2019
Defence time
13:00
Defence place
Segerfalksalen, BMC A10, Sölvegatan 17 i Lund
Opponent
- Bjørn Atle Bjørnbeth (PhD)