Clear Search sequence regions


Sizes of these terms reflect their relevance to your search.

Lack of a liver surgeon (LS) may lead to failure to cure in patients with possibly resectable colorectal liver metastases (CRLM). This study aims to quantify the failure-to-cure rate due to noninclusion of an LS. All patients who underwent chemotherapy with palliative intent for CRLM at a community oncology network between 2010 and 2018 were identified from a prospectively maintained cancer registry. Two LS blinded to patient management and outcome reviewed pretreatment imaging and assigned each scan a newly developed resectability score. Nominal group technique and independent scores were combined to determine probability of curative-intent resection. Interobserver agreement was calculated using κ testing. This study included 72 palliative CRLM patients. Demographic factors were: 44 (59%) male, median age 68 years (range 36-94 years), 23 (32%) rectal primary, 24 (33%) receiving oxaliplatin-based chemotherapy. Of the 72 patients with CRLM, 6 had left-sided metastases only. The median number of CRLM was 6 (1-8). Agreement on resectability was achieved in 32 (44%) patients for the entire cohort and 17 (54%) in patients without extrahepatic disease. A lower median number of CRLM was found in the group considered to be resectable by the two LS (2 versus 8; p = 0.001). Substantial agreement was found between liver surgeons in the group of patients without extrahepatic disease (κ = 0.9043). Over 44% of patients who were assigned palliative chemotherapy at tumor boards without an LS were considered potentially resectable upon independent LS review. © 2021. Society of Surgical Oncology.

Citation

Eduardo A Vega, Omid Salehi, Diana Nicolaescu, Edward-Michael Dussom, Sylvia V Alarcon, Olga Kozyreva, Jana Simonds, Deborah Schnipper, Claudius Conrad. Failure to Cure Patients with Colorectal Liver Metastases: The Impact of the Liver Surgeon. Annals of surgical oncology. 2021 Nov;28(12):7698-7706

Expand section icon Mesh Tags

Expand section icon Substances


PMID: 33939045

View Full Text