High Survival Rate After Two-Stage Resection of Advanced Colorectal Liver Metastases

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dc.contributor.author Brouquet, Antoine
dc.contributor.author Abdalla, Eddie
dc.contributor.author Kopetz, Scott
dc.contributor.author Garrett, Christopher
dc.contributor.author Overman, Micheal
dc.contributor.author Eng, Cathy
dc.contributor.author Andreou, Andreas
dc.contributor.author Loyer, Evelyne
dc.contributor.author Madoff, David
dc.contributor.author Curley, Steven
dc.contributor.author Vauthey, Jean-Nicolas
dc.date.accessioned 2015-11-19T09:46:34Z
dc.date.available 2015-11-19T09:46:34Z
dc.date.copyright 2011
dc.date.issued 2015-11-19
dc.identifier.issn 0732-183X en_US
dc.identifier.uri http://hdl.handle.net/10725/2627
dc.description.abstract 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. en_US
dc.language.iso en en_US
dc.title High Survival Rate After Two-Stage Resection of Advanced Colorectal Liver Metastases en_US
dc.type Article en_US
dc.description.version Published en_US
dc.title.subtitle Response-Based Selection and Complete Resection Define Outcome 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.author.division eddie.abdalla@lau.edu.lb
dc.relation.journal Journal of Clinical Oncology en_US
dc.journal.volume 29 en_US
dc.journal.issue 8 en_US
dc.article.pages 1083-1090 en_US
dc.identifier.doi http://dx.doi.org/10.1200/JCO.2010.32.6132 en_US
dc.identifier.ctation 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. en_US

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