Debunking dogma

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dc.contributor.author Abdalla, Eddie
dc.contributor.author Pawlik, Timothy
dc.contributor.author Vauthey, Nicolas
dc.contributor.author Curley, Steven
dc.date.accessioned 2015-11-12T09:37:58Z
dc.date.available 2015-11-12T09:37:58Z
dc.date.copyright 2006
dc.date.issued 2015-11-12
dc.identifier.issn 1091-255X en_US
dc.identifier.uri http://hdl.handle.net/10725/2544
dc.description.abstract Treatment of four or more colorectal liver metastases (CRLMs) is controversial and remains a relative contraindication to surgery at some institutions. We sought to assess the outcome of patients with four or more CRLMs treated with surgery. Patients (159) with four or more CRLMs were treated surgically at a single institution. The median number of treated lesions was 5 (range, 4–14). The majority of patients received neoadjuvant chemotherapy (89.9%). Forty-six (29.0%) patients underwent resection only, 12 (7.5%) underwent radiofrequency ablation (RFA) only, and 101 (63.5%) underwent resection plus RFA. The 5-year actuarial disease-free and overall survival rates were 21.5% and 50.9%, respectively. Patients who underwent RFA as part of their surgical procedure (hazard ratio [HR] =1.81, P =0.03) and those with a positive surgical resection margin (HR=1.52, P =0.01) were more likely to have a shorter time to recurrence. Patients who did not have a reduction in tumor size following neoadjuvant chemotherapy had a higher likelihood of death following surgical treatment (HR=2.53, P =0.01). Patients with four or more CRLMs should be considered for aggressive surgical treatment, including liver resection with or without RFA, in order to improve the chance of long-term survival. Certain clinicopathologic factors, including lack of response to neoadjuvant chemotherapy, were associated with a worse prognosis. en_US
dc.language.iso en en_US
dc.title Debunking dogma en_US
dc.type Article en_US
dc.description.version Published en_US
dc.title.subtitle Surgery for four or more colorectal liver metastases is justified en_US
dc.author.school SOM en_US
dc.author.idnumber 201100945 en_US
dc.author.woa N/A en_US
dc.author.department N/A en_US
dc.description.embargo N/A en_US
dc.relation.journal Journal of Gastrointestinal Surgery en_US
dc.journal.volume 10 en_US
dc.journal.issue 2 en_US
dc.article.pages 240-248 en_US
dc.keywords Colorectal metastasis en_US
dc.keywords Multiple tumors en_US
dc.keywords Radiofrequency ablation en_US
dc.keywords Resection en_US
dc.keywords Outcome en_US
dc.identifier.doi http://dx.doi.org/10.1016/j.gassur.2005.07.027 en_US
dc.identifier.ctation Pawlik, T. M., Abdalla, E. K., Ellis, L. M., Vauthey, J. N., & Curley, S. A. (2006). Debunking dogma: surgery for four or more colorectal liver metastases is justified. Journal of gastrointestinal surgery, 10(2), 240-248. en_US
dc.author.email eddie.abdalla@lau.edu.lb
dc.identifier.url http://link.springer.com/article/10.1016/j.gassur.2005.07.027

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