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Karaciğer Metastazlı Kolorektal Kanserde Kişiselleştirilmiş Tedavi Sonuçları

Yıl 2020, Cilt: 25 Sayı: 2, 120 - 129, 13.06.2020

Öz

Amaç:
Karaciğer metastazı, kolorektal kansere (KRK) bağlı ölümlerin en sık nedenidir.
Daha iyi sağkalım sonuçları için tekrarlayan karaciğer metastazında
kişiselleştirilmiş agresif lokal tedaviler önerilmektedir. Bu çalışmada seçilmiş
bir grup metastatik KRK hastasında kaydedilen sonuçları paylaşmayı amaçladık.



Gereç ve Yöntemler:
Mart 2013—Kasım 2018 döneminde karaciğer metastazlı KRK tanısı alan ve cerrahi
tedavi uygulanan toplam 45 (28 erkek, 17 kadın) hastanın verileri retrospektif
olarak incelendi.



Bulgular:
Medyan hasta yaşı 61 yıl idi. Senkron metastazı bulunan 32 hastanın 21’i eş
zamanlı ameliyat edildi. Metakron metastaz gelişimi için medyan süre 18 aydı.
Bilober metastazlı 23 hastada medyan metastaz sayısı 4 (1–18) idi. On bir (10
senkron ve 1 metakron metastaz) hastada perioperatif kemoterapi uygulanmadan karaciğer
rezeksiyonu yapıldı; diğer 34 hastada ise perioperatif tedavi uygulandı. Parankim-koruyucu
karaciğer cerrahisi (metastazektomi / segmentektomi) 34 hasta ile en sık uygulanan
cerrahi yaklaşım olurken yine onkolojik prensipler doğrultusunda (31 metastaz
için) 10 hastada cerrahi–ablasyon kombinasyonu uygulandı. Medyan tümör boyutu
35 mm, medyan cerrahi sınır 3 mm idi. Dört hastada cerrahi sınır pozitifti; bu
4 hastadan sadece 1’inde lokal nüks gelişti. Toplam 20 hastada medyan 12 aylık dönemde
reküren karaciğer metastazı gelişti; bu hastalara tekrar cerrahi tedavi
uygulandı. Medyan sağkalım süresi 45 hastanın tümü için 32 ay, nüks nedeniyle ikincil
cerrahi uygulanan 12 hasta içinse 36 ay olarak saptandı.



Tartışma ve Sonuç:
Karaciğer metastazlı KRK’de agresif, kişiselleştirilmiş, multidisipliner
tedaviler daha iyi uzun dönem sağkalım sağlamaktadır. Senkron veya aşamalı
girişimler kabul edilebilir morbidite ve mortalite oranları ile uygulanabilir. Reküren
metastazlarda cerrahi tedavi şansını artırmak için parankim-koruyucu cerrahiler
seçilmelidir.

Kaynakça

  • Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, Rosso S, Coebergh JW, Comber H, Forman D, Bray F. Cancer incidence and mortality patterns in Europe: estimated for 40 countries in 2012. Eur J Cancer 2013 Apr;49(6):1374-403. doi: 10.1016/j.ejca.2012.12.027
  • Brown RE, Bower MR, Martin RC. Hepatic resection for colorectal liver metastases. Surg Clin North Am. 2010 Aug;90(4):839-52. doi: 10.1016/j.suc.2010.04.012
  • Fong Y, Cohen AM, Fortner JG, Enker WE, Turnbull AD, Coit DG, Marrero AM, Prasad M, Blumgart LH, Brennan MF. Liver resection for colorectal metastases. J Clin Oncol. 1997 Mar;15(3):938-46
  • Rees M, Tekkis PP, Welsh FK, O'Rourke T, John TG. Evaluation of long-term survival after hepatic resection for metastatic colorectal cancer: a multifactorial model of 929 patients. Ann Surg. 2008 Jan;247(1):125-35
  • Alvarez FA, Sanchez Claria R, Oggero S, de Santibañes E. Parenchymal-sparing liver surgery in patients with colorectal carcinoma liver metastases. World J Gastrointest Surg. 2016 Jun 27; 8(6):407-23
  • Moris D, Dimitroulis D, Vernadakis S, Papalampros A, Spartalis E, Petrou A, Pawlik TM, Felekouras E. Parenchymal-sparing Hepatectomy as the New Doctrine in the Treatment of Liver-metastatic Colorectal Disease: Beyond Oncological Outcomes. Anticancer Res. 2017 Jan; 37(1):9-14
  • Torzilli G, Viganò L, Cimino M, Imai K, Vibert E, Donadon M, Mansour D, Castaing D, Adam R. Is Enhanced One-Stage Hepatectomy a Safe and Feasible Alternative to the Two-Stage Hepatectomy in the Setting of Multiple Bilobar Colorectal Liver Metastases? A Comparative Analysis between Two Pioneering Centers. Dig Surg. 2018; 35(4):323-332
  • Gold JS, Are C, Kornprat P, Jarnagin WR, Gönen M, Fong Y, DeMatteo RP, Blumgart LH, D'Angelica M. Increased use of parenchymal-sparing surgery for bilateral liver metastases from colorectal cancer is associated with improved mortality without change in oncologic outcome: trends in treatment over time in 440 patients. Ann Surg. 2008 Jan;247(1):109-17
  • Reddy SK, Pawlik TM, Zorzi D, Gleisner AL, Ribero D, Assumpcao L, Barbas AS, Abdalla EK, Choti MA, Vauthey JN, et al. Simultaneous resections of colorectal cancer and synchronous liver metastases: a multi-institutional analysis. Ann Surg Oncol. 2007;14:3481–91
  • Hillingsø JG, Wille-Jørgensen P. Staged or simultaneous resection of synchronous liver metastases from colorectal cancer--a systematic review. Colorectal Dis. 2009 Jan;11(1):3-10. doi: 10.1111/j.1463-1318.2008.01625.
  • Gavriilidis P, Sutcliffe RP, Hodson J, Marudanayagam R, Isaac J, Azoulay D, Roberts KJ. Simultaneous versus delayed hepatectomy for synchronous colorectal liver metastases: a systematic review and meta-analysis. HPB (Oxford) 2018; 20: 11-19 doi: 10.1016/j.hpb.2017.08.008
  • Torzilli G, Adam R, Viganò L, Imai K, Goransky J, Fontana A, Toso C, Majno P, de Santibañes E. Surgery of Colorectal Liver Metastases: Pushing the Limits. Liver Cancer. 2016 Nov;6(1):80-9
  • Rentsch M, Schiergens TS. Treatment plan improvement by multidisciplinary case conferences for patients with colorectal cancer and synchronous liver metastases. Hepatobiliary Surg Nutr. 2018 Apr;7(2):147-148. doi: 10.21037/hbsn.2018.03.05
  • Schiergens TS, von Einem J, Thomas MN, Albertsmeier M, Giessen-Jung C, Dörsch M, Heiliger C, Drefs M, Andrassy J, Modest DP, Stintzing S, Guba M, Angele M, Werner J, Rentsch M. Multidisciplinary treatment of colorectal liver metastases. Minerva Med. 2017 Dec;108(6):527-546. doi: 10.23736/S0026-4806.17.05371-X
  • Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004;240(2):205-13
  • Ferrarotto R, Pathak P, Maru D, Agarwal A, Overman M, Hoff PM, Kopetz S. Durable complete responses in metastatic colorectal cancer treated with chemotherapy alone. Clin Colorectal Cancer. 2011 Sep;10(3):178-82. doi: 10.1016/j.clcc.2011.03.023
  • Tomlinson JS, Jarnagin WR, DeMatteo RP, Fong Y, Kornprat P, Gonen M, Kemeny N, Brennan MF, Blumgart LH, D'Angelica M. Actual 10-year survival after resection of colorectal liver metastases defines cure. J Clin Oncol. 2007 Oct 10;25(29):4575-80
  • Ekberg H, Tranberg KG, Andersson R, Lundstedt C, Hägerstrand I, Ranstam J, Bengmark S. Determinants of survival in liver resection for colorectal secondaries. Br J Surg. 1986 Sep;73(9):727-31
  • Scheele J, Stang R, Altendorf-Hofmann A, Paul M. Resection of colorectal liver metastases. World J Surg. 1995 Jan-Feb;19(1):59-71
  • Ercolani G, Grazi GL, Ravaioli M, Cescon M, Gardini A, Varotti G, Del Gaudio M, Nardo B, Cavallari A. Liver resection for multiple colorectal metastases: influence of parenchymal involvement and total tumor volume, vs number or location, on long-term survival. Arch Surg. 2002 Oct;137(10):1187-92
  • Malik HZ, Hamady ZZ, Adair R, Finch R, Al-Mukhtar A, Toogood GJ, Prasad KR, Lodge JP. Prognostic influence of multiple hepatic metastases from colorectal cancer. Eur J Surg Oncol. 2007 May;33(4):468-73
  • Carlomagno C, De Stefano A, Rosanova M, De Falco S, Attademo L, Fiore G, De Placido S. Multiple treatment lines and prognosis in metastatic colorectal cancer patients. Cancer Metastasis Rev. 2019 Jun;38(1-2):307-313. doi: 10.1007/s10555-018-9748-7
  • Adam R, Delvart V, Pascal G, Valeanu A, Castaing D, Azoulay D, Giacchetti S, Paule B, Kunstlinger F, Ghémard O, Levi F, Bismuth H. Rescue surgery for unresectable colorectal liver metastases downstaged by chemotherapy: a model to predict long-term survival. Ann Surg. 2004 Oct;240(4):644-57
  • Pawlik TM, Vauthey JN. Surgical margins during hepatic surgery for colorectal liver metastases: complete resection not millimeters defines outcome. Ann Surg Oncol. 2008 Mar;15(3):677-9. doi: 10.1245/s10434-007-9703-2
  • Pawlik TM, Scoggins CR, Zorzi D, Abdalla EK, Andres A, Eng C, Curley SA, Loyer EM, Muratore A, Mentha G, Capussotti L, Vauthey JN. Effect of surgical margin status on survival and site of recurrence after hepatic resection for colorectal metastases. Ann Surg. 2005 May;241(5):715-22
  • De Haas RJ, Wicherts DA, Flores E, Azoulay D, Castaing D, Adam R. R1 resection by necessity for colorectal liver metastases: is it still a contraindication to surgery? Ann Surg. 2008 Oct;248(4):626-37. doi: 10.1097/SLA.0b013e31818a07f1
  • Postriganova N, Kazaryan AM, Røsok BI, Fretland Å, Barkhatov L, Edwin B. Margin status after laparoscopic resection of colorectal liver metastases: does a narrow resection margin have an influence on survival and local recurrence? HPB (Oxford). 2014 Sep;16(9):822-9. doi: 10.1111/hpb.12204
  • Temel MK. Sitotoksik kemoterapötiklerin yirminci yüzyıldaki gelişimi [The development of cytotoxic chemotherapeutics in the twentieth century]. Turkish Journal of Oncology. 2015;30(2):96-108.
  • Hugh TJ, Kinsella AR, Poston GJ. Management strategies for colorectal liver metastases--Part II. Surg Oncol. 1997;6(1):31-48
  • Silberhumer GR, Paty PB, Temple LK, Araujo RL, Denton B, Gonen M, Nash GM, Allen PJ, DeMatteo RP, Guillem J, et al. Simultaneous resection for rectal cancer with synchronous liver metastasis is a safe procedure. Am J Surg. 2015;209:935–42
  • Chen J, Li Q, Wang C, Zhu H, Shi Y, Zhao G. Simultaneous vs. staged resection for synchronous colorectal liver metastases: a metaanalysis. Int J Colorectal Dis. 2011 Feb;26(2):191-9. doi: 10.1007/s00384-010-1018-2
  • Yin Z, Liu C, Chen Y, Bai Y, Shang C, Yin R, Yin D, Wang J. Timing of hepatectomy in resectable synchronous colorectal liver metastases (SCRLM): Simultaneous or delayed? Hepatology 2013; 57: 2346-57 doi: 10.1002/hep.26283
  • Slesser AA, Simillis C, Goldin R, Brown G, Mudan S, Tekkis PP. A meta-analysis comparing simultaneous versus delayed resections in patients with synchronous colorectal liver metastases. Surg Oncol 2013; 22: 36-47 doi: 10.1016/ j.suronc.2012.11.002
  • Feng Q, Wei Y, Zhu D, Ye L, Lin Q, Li W, Qin X, Lyu M, Xu J. Timing of hepatectomy for resectable synchronous colorectal liver metastases: for whom simultaneous resection is more suitable--a meta-analysis. PLoS One 2014; 9: e104348 doi: 10.1371/journal.pone.0104348
  • Yang C, Rahbari NN, Mees ST, Schaab F, Koch M, Weitz J, Reissfelder C. Staged resection of bilobar colorectal liver metastases: surgical strategies. Langenbecks Arch Surg. 2015 Aug;400(6):633-40. doi: 10.1007/s00423-015-1310-2
  • Ikoma N, Raghav K, Chang G. An Update on Randomized Clinical Trials in Metastatic Colorectal Carcinoma. Surg Oncol Clin N Am. 2017 Oct;26(4):667-87. doi: 10.1016/j.soc.2017.05.007
  • Waisberg J, Ivankovics IG. Liver-first approach of colorectal cancer with synchronous hepatic metastases: A reverse strategy. World J Hepatol. 2015 Jun 18;7(11):1444-9. doi: 10.4254/wjh.v7.i11.1444
  • Wicherts DA, de Haas RJ, Salloum C, Andreani P, Pascal G, Sotirov D, Adam R, Castaing D, Azoulay D. Repeat hepatectomy for recurrent colorectal metastases. Br J Surg. 2013;100:808–18
  • Adam R, Bismuth H, Castaing D, Waechter F, Navarro F, Abascal A, Majno P, Engerran L. Repeat hepatectomy for colorectal liver metastases. Ann Surg. 1997 Jan;225(1):51-60

Results of Individualized Treatment of Colorectal Cancer with Liver Metastasis

Yıl 2020, Cilt: 25 Sayı: 2, 120 - 129, 13.06.2020

Öz

Aim: Liver metastasis is the most common cause of death in colorectal
cancer (CRC). In cases of recurrent liver metastasis, individualized aggressive
local treatments are recommended for better survival outcomes. In this study, we
aimed to present the health outcomes obtained in a group of highly selected
patients with metastatic CRC.



Materials and
Methods:
Medical records of a total of
45 (28 males, 17 females) patients who were diagnosed with CRC with liver
metastasis and underwent surgical treatment between March 2013 and November
2018 were reviewed retrospectively.



Results: The median patient age was 61 years. Thirty-two
patients were diagnosed with synchronous metastasis, of whom 21 underwent synchronous
surgery. The median time for metachronous metastasis development was 18 months.
Twenty-three patients developed bilobar metastasis, with a median number of 4
(1–18) metastases. Eleven (10 synchronous and 1 metachronous metastasis) patients
underwent liver resection without perioperative chemotherapy while the other 34
received perioperative treatment. While parenchyma-preserving liver surgery (metastasectomy/segmentectomy)
as performed in 34 patients was the most common surgical approach, surgery in
10 patients (for 31 metastasis) was combined with ablation, again in accordance
with the oncological principles. The median tumor size and surgical margin were
35 mm and 3 mm, respectively. Surgical margin was positive in 4 patients, of
whom only 1 developed local recurrences. In a median time of 12 months, a total
of 20 patients developed recurrent liver metastasis, and 12 of them underwent surgery
again. The median survival was 32 months for all 45 patients and 36 months for the
12 patients who underwent secondary surgery due to recurrence.



Discussion
and Conclusion:
Aggressive,
individualized, multidisciplinary treatments could provide better long-term survival
outcomes in CRC with liver metastasis. Synchronous or staged interventions are
applicable with acceptable morbidity and mortality rates. In cases of recurrent
metastasis, parenchyma-preserving procedures should be preferred for increased
chances of repeated surgical treatment.  

Kaynakça

  • Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, Rosso S, Coebergh JW, Comber H, Forman D, Bray F. Cancer incidence and mortality patterns in Europe: estimated for 40 countries in 2012. Eur J Cancer 2013 Apr;49(6):1374-403. doi: 10.1016/j.ejca.2012.12.027
  • Brown RE, Bower MR, Martin RC. Hepatic resection for colorectal liver metastases. Surg Clin North Am. 2010 Aug;90(4):839-52. doi: 10.1016/j.suc.2010.04.012
  • Fong Y, Cohen AM, Fortner JG, Enker WE, Turnbull AD, Coit DG, Marrero AM, Prasad M, Blumgart LH, Brennan MF. Liver resection for colorectal metastases. J Clin Oncol. 1997 Mar;15(3):938-46
  • Rees M, Tekkis PP, Welsh FK, O'Rourke T, John TG. Evaluation of long-term survival after hepatic resection for metastatic colorectal cancer: a multifactorial model of 929 patients. Ann Surg. 2008 Jan;247(1):125-35
  • Alvarez FA, Sanchez Claria R, Oggero S, de Santibañes E. Parenchymal-sparing liver surgery in patients with colorectal carcinoma liver metastases. World J Gastrointest Surg. 2016 Jun 27; 8(6):407-23
  • Moris D, Dimitroulis D, Vernadakis S, Papalampros A, Spartalis E, Petrou A, Pawlik TM, Felekouras E. Parenchymal-sparing Hepatectomy as the New Doctrine in the Treatment of Liver-metastatic Colorectal Disease: Beyond Oncological Outcomes. Anticancer Res. 2017 Jan; 37(1):9-14
  • Torzilli G, Viganò L, Cimino M, Imai K, Vibert E, Donadon M, Mansour D, Castaing D, Adam R. Is Enhanced One-Stage Hepatectomy a Safe and Feasible Alternative to the Two-Stage Hepatectomy in the Setting of Multiple Bilobar Colorectal Liver Metastases? A Comparative Analysis between Two Pioneering Centers. Dig Surg. 2018; 35(4):323-332
  • Gold JS, Are C, Kornprat P, Jarnagin WR, Gönen M, Fong Y, DeMatteo RP, Blumgart LH, D'Angelica M. Increased use of parenchymal-sparing surgery for bilateral liver metastases from colorectal cancer is associated with improved mortality without change in oncologic outcome: trends in treatment over time in 440 patients. Ann Surg. 2008 Jan;247(1):109-17
  • Reddy SK, Pawlik TM, Zorzi D, Gleisner AL, Ribero D, Assumpcao L, Barbas AS, Abdalla EK, Choti MA, Vauthey JN, et al. Simultaneous resections of colorectal cancer and synchronous liver metastases: a multi-institutional analysis. Ann Surg Oncol. 2007;14:3481–91
  • Hillingsø JG, Wille-Jørgensen P. Staged or simultaneous resection of synchronous liver metastases from colorectal cancer--a systematic review. Colorectal Dis. 2009 Jan;11(1):3-10. doi: 10.1111/j.1463-1318.2008.01625.
  • Gavriilidis P, Sutcliffe RP, Hodson J, Marudanayagam R, Isaac J, Azoulay D, Roberts KJ. Simultaneous versus delayed hepatectomy for synchronous colorectal liver metastases: a systematic review and meta-analysis. HPB (Oxford) 2018; 20: 11-19 doi: 10.1016/j.hpb.2017.08.008
  • Torzilli G, Adam R, Viganò L, Imai K, Goransky J, Fontana A, Toso C, Majno P, de Santibañes E. Surgery of Colorectal Liver Metastases: Pushing the Limits. Liver Cancer. 2016 Nov;6(1):80-9
  • Rentsch M, Schiergens TS. Treatment plan improvement by multidisciplinary case conferences for patients with colorectal cancer and synchronous liver metastases. Hepatobiliary Surg Nutr. 2018 Apr;7(2):147-148. doi: 10.21037/hbsn.2018.03.05
  • Schiergens TS, von Einem J, Thomas MN, Albertsmeier M, Giessen-Jung C, Dörsch M, Heiliger C, Drefs M, Andrassy J, Modest DP, Stintzing S, Guba M, Angele M, Werner J, Rentsch M. Multidisciplinary treatment of colorectal liver metastases. Minerva Med. 2017 Dec;108(6):527-546. doi: 10.23736/S0026-4806.17.05371-X
  • Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004;240(2):205-13
  • Ferrarotto R, Pathak P, Maru D, Agarwal A, Overman M, Hoff PM, Kopetz S. Durable complete responses in metastatic colorectal cancer treated with chemotherapy alone. Clin Colorectal Cancer. 2011 Sep;10(3):178-82. doi: 10.1016/j.clcc.2011.03.023
  • Tomlinson JS, Jarnagin WR, DeMatteo RP, Fong Y, Kornprat P, Gonen M, Kemeny N, Brennan MF, Blumgart LH, D'Angelica M. Actual 10-year survival after resection of colorectal liver metastases defines cure. J Clin Oncol. 2007 Oct 10;25(29):4575-80
  • Ekberg H, Tranberg KG, Andersson R, Lundstedt C, Hägerstrand I, Ranstam J, Bengmark S. Determinants of survival in liver resection for colorectal secondaries. Br J Surg. 1986 Sep;73(9):727-31
  • Scheele J, Stang R, Altendorf-Hofmann A, Paul M. Resection of colorectal liver metastases. World J Surg. 1995 Jan-Feb;19(1):59-71
  • Ercolani G, Grazi GL, Ravaioli M, Cescon M, Gardini A, Varotti G, Del Gaudio M, Nardo B, Cavallari A. Liver resection for multiple colorectal metastases: influence of parenchymal involvement and total tumor volume, vs number or location, on long-term survival. Arch Surg. 2002 Oct;137(10):1187-92
  • Malik HZ, Hamady ZZ, Adair R, Finch R, Al-Mukhtar A, Toogood GJ, Prasad KR, Lodge JP. Prognostic influence of multiple hepatic metastases from colorectal cancer. Eur J Surg Oncol. 2007 May;33(4):468-73
  • Carlomagno C, De Stefano A, Rosanova M, De Falco S, Attademo L, Fiore G, De Placido S. Multiple treatment lines and prognosis in metastatic colorectal cancer patients. Cancer Metastasis Rev. 2019 Jun;38(1-2):307-313. doi: 10.1007/s10555-018-9748-7
  • Adam R, Delvart V, Pascal G, Valeanu A, Castaing D, Azoulay D, Giacchetti S, Paule B, Kunstlinger F, Ghémard O, Levi F, Bismuth H. Rescue surgery for unresectable colorectal liver metastases downstaged by chemotherapy: a model to predict long-term survival. Ann Surg. 2004 Oct;240(4):644-57
  • Pawlik TM, Vauthey JN. Surgical margins during hepatic surgery for colorectal liver metastases: complete resection not millimeters defines outcome. Ann Surg Oncol. 2008 Mar;15(3):677-9. doi: 10.1245/s10434-007-9703-2
  • Pawlik TM, Scoggins CR, Zorzi D, Abdalla EK, Andres A, Eng C, Curley SA, Loyer EM, Muratore A, Mentha G, Capussotti L, Vauthey JN. Effect of surgical margin status on survival and site of recurrence after hepatic resection for colorectal metastases. Ann Surg. 2005 May;241(5):715-22
  • De Haas RJ, Wicherts DA, Flores E, Azoulay D, Castaing D, Adam R. R1 resection by necessity for colorectal liver metastases: is it still a contraindication to surgery? Ann Surg. 2008 Oct;248(4):626-37. doi: 10.1097/SLA.0b013e31818a07f1
  • Postriganova N, Kazaryan AM, Røsok BI, Fretland Å, Barkhatov L, Edwin B. Margin status after laparoscopic resection of colorectal liver metastases: does a narrow resection margin have an influence on survival and local recurrence? HPB (Oxford). 2014 Sep;16(9):822-9. doi: 10.1111/hpb.12204
  • Temel MK. Sitotoksik kemoterapötiklerin yirminci yüzyıldaki gelişimi [The development of cytotoxic chemotherapeutics in the twentieth century]. Turkish Journal of Oncology. 2015;30(2):96-108.
  • Hugh TJ, Kinsella AR, Poston GJ. Management strategies for colorectal liver metastases--Part II. Surg Oncol. 1997;6(1):31-48
  • Silberhumer GR, Paty PB, Temple LK, Araujo RL, Denton B, Gonen M, Nash GM, Allen PJ, DeMatteo RP, Guillem J, et al. Simultaneous resection for rectal cancer with synchronous liver metastasis is a safe procedure. Am J Surg. 2015;209:935–42
  • Chen J, Li Q, Wang C, Zhu H, Shi Y, Zhao G. Simultaneous vs. staged resection for synchronous colorectal liver metastases: a metaanalysis. Int J Colorectal Dis. 2011 Feb;26(2):191-9. doi: 10.1007/s00384-010-1018-2
  • Yin Z, Liu C, Chen Y, Bai Y, Shang C, Yin R, Yin D, Wang J. Timing of hepatectomy in resectable synchronous colorectal liver metastases (SCRLM): Simultaneous or delayed? Hepatology 2013; 57: 2346-57 doi: 10.1002/hep.26283
  • Slesser AA, Simillis C, Goldin R, Brown G, Mudan S, Tekkis PP. A meta-analysis comparing simultaneous versus delayed resections in patients with synchronous colorectal liver metastases. Surg Oncol 2013; 22: 36-47 doi: 10.1016/ j.suronc.2012.11.002
  • Feng Q, Wei Y, Zhu D, Ye L, Lin Q, Li W, Qin X, Lyu M, Xu J. Timing of hepatectomy for resectable synchronous colorectal liver metastases: for whom simultaneous resection is more suitable--a meta-analysis. PLoS One 2014; 9: e104348 doi: 10.1371/journal.pone.0104348
  • Yang C, Rahbari NN, Mees ST, Schaab F, Koch M, Weitz J, Reissfelder C. Staged resection of bilobar colorectal liver metastases: surgical strategies. Langenbecks Arch Surg. 2015 Aug;400(6):633-40. doi: 10.1007/s00423-015-1310-2
  • Ikoma N, Raghav K, Chang G. An Update on Randomized Clinical Trials in Metastatic Colorectal Carcinoma. Surg Oncol Clin N Am. 2017 Oct;26(4):667-87. doi: 10.1016/j.soc.2017.05.007
  • Waisberg J, Ivankovics IG. Liver-first approach of colorectal cancer with synchronous hepatic metastases: A reverse strategy. World J Hepatol. 2015 Jun 18;7(11):1444-9. doi: 10.4254/wjh.v7.i11.1444
  • Wicherts DA, de Haas RJ, Salloum C, Andreani P, Pascal G, Sotirov D, Adam R, Castaing D, Azoulay D. Repeat hepatectomy for recurrent colorectal metastases. Br J Surg. 2013;100:808–18
  • Adam R, Bismuth H, Castaing D, Waechter F, Navarro F, Abascal A, Majno P, Engerran L. Repeat hepatectomy for colorectal liver metastases. Ann Surg. 1997 Jan;225(1):51-60
Toplam 39 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm ORJİNAL MAKALE
Yazarlar

Kursat R. Serin Bu kişi benim 0000-0001-9023-9151

Muhammed Z. Ucuncu 0000-0003-4638-1059

Onder Karabay 0000-0002-3797-0102

M. Kemal Temel 0000-0003-2533-8641

Adnan Hacim 0000-0002-3906-2538

Cem Terzi Bu kişi benim 0000-0003-2523-5140

Yayımlanma Tarihi 13 Haziran 2020
Kabul Tarihi 27 Nisan 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 25 Sayı: 2

Kaynak Göster

Vancouver Serin KR, Ucuncu MZ, Karabay O, Temel MK, Hacim A, Terzi C. Results of Individualized Treatment of Colorectal Cancer with Liver Metastasis. Anadolu Klin. 2020;25(2):120-9.

13151 This Journal licensed under a CC BY-NC (Creative Commons Attribution-NonCommercial 4.0) International License.