High Survival Rate After Two-Stage Resection of Advanced Colorectal Liver Metastases
Purpose Prolonged survival after two-stage resection (TSR) of advanced colorectal liver metastases (CLM) may be the result of selection of best responders to chemotherapy. The impact of complete resection in this well-selected group is controversial. Patients and Methods Data on 890 patients undergo...
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| مؤلفون آخرون: | , , , , , , , , , |
| التنسيق: | article |
| منشور في: |
2011
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| الوصول للمادة أونلاين: | http://hdl.handle.net/10725/2627 http://dx.doi.org/10.1200/JCO.2010.32.6132 |
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| _version_ | 1864513458983141376 |
|---|---|
| author | Brouquet, Antoine |
| author2 | Abdalla, Eddie Kopetz, Scott Garrett, Christopher Overman, Micheal Eng, Cathy Andreou, Andreas Loyer, Evelyne Madoff, David Curley, Steven Vauthey, Jean-Nicolas |
| author2_role | author author author author author author author author author author |
| author_facet | Brouquet, Antoine Abdalla, Eddie Kopetz, Scott Garrett, Christopher Overman, Micheal Eng, Cathy Andreou, Andreas Loyer, Evelyne Madoff, David Curley, Steven Vauthey, Jean-Nicolas |
| author_role | author |
| dc.creator.none.fl_str_mv | Brouquet, Antoine Abdalla, Eddie Kopetz, Scott Garrett, Christopher Overman, Micheal Eng, Cathy Andreou, Andreas Loyer, Evelyne Madoff, David Curley, Steven Vauthey, Jean-Nicolas |
| dc.date.none.fl_str_mv | 2011 2015-11-19T09:46:34Z 2015-11-19T09:46:34Z 2015-11-19 |
| dc.identifier.none.fl_str_mv | 0732-183X http://hdl.handle.net/10725/2627 http://dx.doi.org/10.1200/JCO.2010.32.6132 Brouquet, A., Abdalla, E. K., Kopetz, S., Garrett, C. R., Overman, M. J., Eng, C., ... & Vauthey, J. N. (2011). High survival rate after two-stage resection of advanced colorectal liver metastases: response-based selection and complete resection define outcome. Journal of Clinical Oncology, 29(8), 1083-1090. |
| dc.language.none.fl_str_mv | en |
| dc.relation.none.fl_str_mv | Journal of Clinical Oncology |
| dc.rights.*.fl_str_mv | info:eu-repo/semantics/openAccess |
| dc.title.none.fl_str_mv | High Survival Rate After Two-Stage Resection of Advanced Colorectal Liver Metastases Response-Based Selection and Complete Resection Define Outcome |
| dc.type.none.fl_str_mv | Article info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/article |
| description | Purpose Prolonged survival after two-stage resection (TSR) of advanced colorectal liver metastases (CLM) may be the result of selection of best responders to chemotherapy. The impact of complete resection in this well-selected group is controversial. Patients and Methods Data on 890 patients undergoing resection and 879 patients who received only chemotherapy for CLM were collected prospectively. We used intent-to-treat analysis to evaluate the survival of patients who underwent TSR. Additionally, we evaluated a cohort of nonsurgically treated patients selected to mirror the TSR population: colorectal metastases with liver-only disease, objective response to chemotherapy, and alive 1 year after chemotherapy initiation. Results Sixty-five patients underwent the first stage of TSR; 62 patients fulfilled the inclusion criteria for the medical group. TSR patients had a mean of 6.7 ± 3.4 CLM with mean size of 4.5 ± 3.1 cm. Nonsurgical patients had a mean of 5.9 ± 2.9 CLM with mean size of 5.4 ± 3.4 cm (not significant). Forty-seven TSR patients (72%) completed the second stage. Progression between stages was the main cause of noncompletion of the second stage (61%). After 50 months median follow-up, the 5-year survival rate was 51% in the TSR group and 15% in the medical group (P = .005). In patients who underwent TSR, noncompletion of TSR and major postoperative complications were independently associated with worse survival. Conclusion TSR is associated with excellent outcome in patients with advanced CLM as a result of both selection by chemotherapy and complete resection of metastatic disease. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | LAURepo_456718c3930f78e84ccb4dbf6be6d1ee |
| identifier_str_mv | 0732-183X Brouquet, A., Abdalla, E. K., Kopetz, S., Garrett, C. R., Overman, M. J., Eng, C., ... & Vauthey, J. N. (2011). High survival rate after two-stage resection of advanced colorectal liver metastases: response-based selection and complete resection define outcome. Journal of Clinical Oncology, 29(8), 1083-1090. |
| language_invalid_str_mv | en |
| network_acronym_str | LAURepo |
| network_name_str | Lebanese American University repository |
| oai_identifier_str | oai:laur.lau.edu.lb:10725/2627 |
| publishDate | 2011 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| spelling | High Survival Rate After Two-Stage Resection of Advanced Colorectal Liver MetastasesResponse-Based Selection and Complete Resection Define OutcomeBrouquet, AntoineAbdalla, EddieKopetz, ScottGarrett, ChristopherOverman, MichealEng, CathyAndreou, AndreasLoyer, EvelyneMadoff, DavidCurley, StevenVauthey, Jean-NicolasPurpose Prolonged survival after two-stage resection (TSR) of advanced colorectal liver metastases (CLM) may be the result of selection of best responders to chemotherapy. The impact of complete resection in this well-selected group is controversial. Patients and Methods Data on 890 patients undergoing resection and 879 patients who received only chemotherapy for CLM were collected prospectively. We used intent-to-treat analysis to evaluate the survival of patients who underwent TSR. Additionally, we evaluated a cohort of nonsurgically treated patients selected to mirror the TSR population: colorectal metastases with liver-only disease, objective response to chemotherapy, and alive 1 year after chemotherapy initiation. Results Sixty-five patients underwent the first stage of TSR; 62 patients fulfilled the inclusion criteria for the medical group. TSR patients had a mean of 6.7 ± 3.4 CLM with mean size of 4.5 ± 3.1 cm. Nonsurgical patients had a mean of 5.9 ± 2.9 CLM with mean size of 5.4 ± 3.4 cm (not significant). Forty-seven TSR patients (72%) completed the second stage. Progression between stages was the main cause of noncompletion of the second stage (61%). After 50 months median follow-up, the 5-year survival rate was 51% in the TSR group and 15% in the medical group (P = .005). In patients who underwent TSR, noncompletion of TSR and major postoperative complications were independently associated with worse survival. Conclusion TSR is associated with excellent outcome in patients with advanced CLM as a result of both selection by chemotherapy and complete resection of metastatic disease.PublishedN/A2015-11-19T09:46:34Z2015-11-19T09:46:34Z20112015-11-19Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article0732-183Xhttp://hdl.handle.net/10725/2627http://dx.doi.org/10.1200/JCO.2010.32.6132Brouquet, A., Abdalla, E. K., Kopetz, S., Garrett, C. R., Overman, M. J., Eng, C., ... & Vauthey, J. N. (2011). High survival rate after two-stage resection of advanced colorectal liver metastases: response-based selection and complete resection define outcome. Journal of Clinical Oncology, 29(8), 1083-1090.enJournal of Clinical Oncologyinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/26272016-08-25T10:05:58Z |
| spellingShingle | High Survival Rate After Two-Stage Resection of Advanced Colorectal Liver Metastases Brouquet, Antoine |
| status_str | publishedVersion |
| title | High Survival Rate After Two-Stage Resection of Advanced Colorectal Liver Metastases |
| title_full | High Survival Rate After Two-Stage Resection of Advanced Colorectal Liver Metastases |
| title_fullStr | High Survival Rate After Two-Stage Resection of Advanced Colorectal Liver Metastases |
| title_full_unstemmed | High Survival Rate After Two-Stage Resection of Advanced Colorectal Liver Metastases |
| title_short | High Survival Rate After Two-Stage Resection of Advanced Colorectal Liver Metastases |
| title_sort | High Survival Rate After Two-Stage Resection of Advanced Colorectal Liver Metastases |
| url | http://hdl.handle.net/10725/2627 http://dx.doi.org/10.1200/JCO.2010.32.6132 |