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Search: onr:"swepub:oai:lup.lub.lu.se:0a69d701-9393-4d78-a737-88a3d5f7270d" > The liver-first app...

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  • Zeyara, AdamLund University,Lunds universitet,Kirurgi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Surgery (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Ystad Hospital (author)

The liver-first approach for synchronous colorectal liver metastases: A systematic review and meta-analysis of completion rates and effects on survival

  • Article/chapterEnglish2021

Publisher, publication year, extent ...

  • 2021-10-03
  • SAGE Publications,2021

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  • LIBRIS-ID:oai:lup.lub.lu.se:0a69d701-9393-4d78-a737-88a3d5f7270d
  • https://lup.lub.lu.se/record/0a69d701-9393-4d78-a737-88a3d5f7270dURI
  • https://doi.org/10.1177/14574969211030131DOI

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  • Language:English
  • Summary in:English

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  • Background: Patients presenting with synchronous colorectal liver metastases are increasinglybeing considered for a curative treatment, and the liver-first approach is gaining popularity in thiscontext. However, little is known about the completion rates of the liver-first approach and itseffects on survival.Methods:A systematic review and meta-analysis of liver-first strategy for colorectal liver metastasis.The primary outcome was an assessment of the completion rates of the liver-first approach.Secondary outcomes included overall survival, causes of non-completion, and clinicopathologicdata.Results: Seventeen articles were amenable for inclusion and the total study population was 1041.The median completion rate for the total population was 80% (range 20–100). The median overallsurvival for the completion and non-completion groups was 45 (range 12–69) months and 13 (range10.5–25) months, respectively. Metadata showed a significant survival benefit for the completiongroup, with a univariate hazard ratio of 12.0 (95% confidence interval, range 5.7–24.4). The majorcause of non-completion (76%) was liver disease progression before resection of the primarytumor. Pearson tests showed significant negative correlation between median number of lesionsand median size of the largest metastasis and completion rate.Conclusions: The liver-first approach offers a complete resection to most patients enrolled, withan overall survival benefit when completion can be assured. One-fifth fails to return to intendedoncologic therapy and the major cause is interim metastatic progression, most often in the liver.Risk of non-completion is related to a higher number of lesions and large metastases. The majorityof studies stem from primary

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  • Torén, WilliamLund University,Lunds universitet,Lever-, pankreas- och gallvägskirurgi,Forskargrupper vid Lunds universitet,Hepato-Pancreato-Biliary Surgery,Lund University Research Groups(Swepub:lu)wi0485to (author)
  • Søreide, KjetilStavanger University Hospital,University of Bergen (author)
  • Andersson, RolandLund University,Lunds universitet,Lever-, pankreas- och gallvägskirurgi,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Hepato-Pancreato-Biliary Surgery,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments(Swepub:lu)kir-ran (author)
  • Kirurgi, LundSektion V (creator_code:org_t)

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  • In:Scandinavian Journal of Surgery: SAGE Publications1799-72671457-4969

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Zeyara, Adam
Torén, William
Søreide, Kjetil
Andersson, Rolan ...
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MEDICAL AND HEALTH SCIENCES
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Scandinavian Jou ...
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Lund University

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