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Outcomes of liver-first strategy and classical strategy for synchronous colorectal liver metastases in Sweden
Lund Univ, Sweden.
Lund Univ, Sweden.
Lund Univ, Sweden.
Uppsala Univ, Sweden.
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2018 (English)In: HPB, ISSN 1365-182X, E-ISSN 1477-2574, Vol. 20, no 5, p. 441-447Article in journal (Refereed) Published
Abstract [en]

Background: Patients with synchronous colorectal liver metastases (sCRLM) are increasingly operated with liver resection before resection of the primary cancer. The aim of this study was to compare outcomes in patients following the liver-first strategy and the classical strategy (resection of the bowel first) using prospectively registered data from two nationwide registries. Methods: Clinical, pathological and survival outcomes were compared between the liver-first strategy and the classical strategy (2008-2015). Overall survival was calculated. Results: A total of 623 patients were identified, of which 246 were treated with the liver-first strategy and 377 with the classical strategy. The median follow-up was 40 months. Patients chosen for the classical strategy more often had T4 primary tumours (23% vs 14%, P = 0.012) and node-positive primaries (70 vs 61%, P = 0.015). The liver-first patients had a higher liver tumour burden score (4.1 (2.5-6.3) vs 3.6 (2.2-5.1), P = 0.003). No difference was seen in five-year overall survival between the groups (54% vs 49%, P = 0.344). A majority (59%) of patients with rectal cancer were treated with the liver-first strategy. Conclusion: The liver-first strategy is currently the dominant strategy for sCRLM in patients with rectal cancer in Sweden. No difference in overall survival was noted between strategies.

Place, publisher, year, edition, pages
ELSEVIER SCI LTD , 2018. Vol. 20, no 5, p. 441-447
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Gastroenterology and Hepatology
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URN: urn:nbn:se:liu:diva-148105DOI: 10.1016/j.hpb.2017.11.004ISI: 000432334300010PubMedID: 29242035OAI: oai:DiVA.org:liu-148105DiVA, id: diva2:1211314
Available from: 2018-05-30 Created: 2018-05-30 Last updated: 2018-05-30

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Sandström, Per
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Division of Surgery, Orthopedics and OncologyFaculty of Medicine and Health SciencesDepartment of Surgery in Linköping
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  • apa
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