Annals of Coloproctology

Display

Sort by :

Original Articles

Outcomes of a Hepatic Resection for Colorectal-Carcinoma Liver Metastases.: Lee, Woo Koung , Kim, Sang Bum , Cho, Eung Ho , Hwang, Dae Yong , Moon, Sun Mi; J Korean Soc Coloproctol. 2010;26(3):204-210.; DOI: https://doi.org/10.3393/jksc.2010.26.3.204

2,318 View
14 Download
1 Citations

PURPOSE
Recent managements of liver metastasis from colorectal cancer consist of multi-disciplinary treatments. Although hepatic resection is the only curative treatment, for which long-term survival is expected, the recurrence rates is still high. Recently, liver resections, combined with chemotherapy and other additional therapy, have produced promising outcomes. We analyzed the outcomes of hepatic resection for liver metastasis from colorectal cancer.
METHODS
From 1993 to 2007, we performed 116 hepatic resections for the treatment of liver metastasis from colorectal cancer. All patients received adjuvant chemotherapy. We reviewed their medical records and investigated the clinico-pathologic data retrospectively.
RESULTS
One in hospital mortality occurred, and the postoperative morbidity rate was 37.5%, including major complication (11.7%). Five-yr overall survival rate and disease free survival rate were 33.2% and 25.0%, respectively. T stage and postoperative morbidity were independent prognostic factors for survival whereas metachronous metastases and postoperative morbidity were independent prognostic factors for recurrence. During the follow-up periods, 67 recurrences occurred.
CONCLUSION
Hepatic resections for liver metastasis from colorectal cancer were safe and effective. The surgical T stage, complications, and metastasis type (metachronous or synchronous) may determine the results in patients with surgically-curable liver metastasis from colorectal cancer.

Citations

Citations to this article as recorded by

Scoring of prognostic factors that influence long-term survival in patients with hepatic metastasis of colorectal cancer
Sung Woo Ahn, Ahn Soo Na, Jae Do Yang, Hong Pil Hwang, Hee Chul Yu, Baik Hwan Cho
Korean Journal of Hepato-Biliary-Pancreatic Surgery.2011; 15(3): 146. CrossRef

Curative Resection Following Neoadjuvant Chemotherapy Including a Molecularly Targeted Agent in Patients with Unresectable Colorectal Distant Metastases.: Kim, Jin Soo , Min, Byung Soh , Hur, Hyuk , Kim, Nam Kyu , Choi, Jin Sub , Sohn, Seung Kook , Cho, Chang Hwan , Ahn, Joong Bae , Roh, Jae Kyung; J Korean Soc Coloproctol. 2008;24(3):184-191.; DOI: https://doi.org/10.3393/jksc.2008.24.3.184

2,027 View
9 Download

Abstract PDF: PURPOSE
A colorectal carcinoma is the fourth most common malignancy in the world. Unfortunately, only approximately 20% of the liver metastases are resectable at the initial presentation. Neoadjuvant chemotherapy has been used for downsizing in unresectable disease. In addition, the use of newer biologic agents, such as cetuximab and bevacizumab, has much improved responses in patients with unresectable colorectal liver metastases. The aim of this study was to report on patients who had received a curative resection following neoadjuvant chemotherapy including a molecularly targeted agent for unresectable colorectal liver metastases.
METHODS
Following the neoadjuvant chemotherapy using cetuximab plus FOLFIRI (irinotecan and infused fluorouracil plus leucovorin) or bevacizumab plus FOLFOX (oxaliplatin and infused fluorouracil plus leucovorin), 10 patients with initially unresectable colorectal liver metastases underwent a curative surgical resection between September 2005 and June 2007. RESULTS: One patient underwent a right lobectomy, three patients a segmentectomy and five a wedge resection with or without radiofrequency ablation. With a median postoperative follow-up of 14 months (range, 1 to 22 months), five recurrences (50%) occurred. The common toxic effects were grade 2/3 skin toxicity (60%), grade 4 hematologic toxicity (20%), grade 3 gastrointestinal toxicity (10%), and grade 3 neurologic toxicity (10%).
CONCLUSIONS
Our preliminary data suggests that neoadjuvant chemotherapy including a molecularly targeted agent may improve resectability in patients with initially unresectable colorectal liver metastases although a high recurrence rate exists. Randomized prospective studies comparing neoadjuvant chemotherapy including a targeted agent in cases of unresectable colorectal liver metastases are warranted.

Differential Expressions of Genes in Colorectal Cancer with Liver Metastasis by using a cDNA Microarray Chip: A Pilot Study.: Kim, Jae O , Choi, Gyu Seog , Kim, Sang Geol , Chang, Eun Jung , Kim, Woo Ri , Lee, In Taek , Jun, Soo Han , Kim, Mun Kyu , Kim, Jeong Chul; J Korean Soc Coloproctol. 2007;23(2):116-128.; DOI: https://doi.org/10.3393/jksc.2007.23.2.116

2,282 View
20 Download

Abstract PDF: PURPOSE
Liver metastasis is the most common type of failure in the treatment of colorectal cancer. The identification of differential expressions of genes in colorectal cancer and liver metastasis is important to differentiate the genetic mechanism of carcinogenesis and liver metastasis from that of a normal mucosa. The aim of this study is to find candidate genes playing roles in liver metastasis of colorectal cancer by using cDNA microarray.
METHODS
We screened a group of genes differentially expressed in a normal mucosa and in cancer and liver metastasis by using a 4.7 K cDNA microarray chip in 8 patients with far advanced colorectal cancer from Jan 2003 to May 2004 at Kyungpook National University Hospital.
RESULTS
A comparison of mRNA expressions of genes in normal mucosa vs. cancer, normal mucosa vs. liver metastasis, and cancer vs. liver metastasis, 76 and 27 known and unknown genes were significantly over-expressed in cancer and liver metastasis, respectively. Also 62 and 26 genes were down- regulated in cancer and liver metastasis. Among those genes, TIMP-1, SRY-box9, Rattus norvegicus fibronectin 1, mitotic check point regulator, etc. were constantly up- regulated in cancer or metastasis, and hsgk, etc. were down-regulated in cancer or liver metastasis. CONSLUSIONS: The cDNA microarray chip technique could be a useful for robust screening of candidate genes involved in carcinogenesis or metastasis of colorectal cancer.

Prevalence of Liver Metastasis of Colorectal Cancer According to Clinical and Histopathologic Characteristics.: Ryu, Dong Won , Lee, Seung Hyun , Ahn, Byung Kwon , Baek, Sung Uhn; J Korean Soc Coloproctol. 2002;18(4):246-250.

1,524 View
4 Download

Abstract PDF: PURPOSE
In Korea, the incidence of colorectal cancer is increasing quickly. The liver metastasis is the most common cause of death. But current diagnosis methods such as CT, MRI, USG have significant false negative rate (up to 15%) especially in micrometastasis. We designed this study to identify the predictive value of liver metastasis of known clinical and histopathologic factors.
METHODS
Retrospectively, we reviewed 248 patients who underwent resection of colorectal cancer between 1997 and 1999. Clinical and histopathologic factors of colorectal cancer with synchronous liver metastasis was compared with those without liver metastasis.
RESULTS
Twenty-nine patients had synchronous liver metastasis. In clinical factors, there was significant difference in liver metastatic rate according to tumors location, and serum carcinoembryonic antigen (CEA). The metastatic rate of right colon was 9.5%, left colon was 27.9%, rectum was 8.0% (P=0.001). The metastatic rate in cases with CEA<5.0 ng/ml was 4.3%, CEA> or =5.0 ng/ml was 18.4% (P=0.001). In histopathologic factors, there was significant difference in liver metastatic rate according to depth of tumor invasion (T-stage), extent of lymph node metastasis (N-stage), venous invasion (9.5 vs 19.3 %, P=0.043), perineural invasion (8.5 vs 19.7 %, P=0.013). The metastatic rate of T1 was 0%, T2 was 3.43%, T3 was 12.3%, T4 was 26.9% (P=0.009). The metastatic rate of N0 was 4.9%, N1 was 15.6%, N2 was 30.3% (P=0.002). But there was no significant difference according to tumor size, histologic differentiation grade, lymphatic invasion. In multi- variant analysis with significant factors, independent factor associated with liver metastasis was N-stage.
CONCLUSIONS
In colorectal cancer, tumor location, CEA, T-stage, N-stage, venous invasion, and perineural invasion of tumor cell had significant relationship with liver metastasis. The most important factor associated with liver metastasis was N-stage. This factors shoud be considered carefully in the planning treatment and follow up in colorectal cancer.

Short-term Results of Radiofrequency Ablation for Liver Metastasis of Colorectal Cancer.: Choi, Sung Il , Chang, Weon Young , Paik, Kwnag Yeool , Lee, Doo Seok , Oh, So Hyang , Kim, Jeong Han , Heo, Jin Seok , Lee, Woo Yong , Kim, Seung Hoon , Lee, Won Jae , Lim, Hyo Keun , Lim, Jae Hoon , Joh, Jae Won , Chun, Ho Kyung; J Korean Soc Coloproctol. 2002;18(1):53-58.

1,352 View
22 Download

Abstract PDF: PURPOSE
Radiofrequency ablation (RFA) is emerging as a new therapeutic method for the management of hepatic malignancy. We report our experience on the use of his technique for the management of liver metastasis of colorectal cancer.
METHODS
All 32 colorectal cancer patients with synchronous or metachronous liver metastasis treated with RFA from May 1999 to May 2001 were reviewed using retrospective method including chart review and telephone interview. All patients were followed up postoperatively to assess complications, complete necrosis, local recurrence, and survival rate.
RESULTS
Forty-one RFA sessions were performed on 70 metastatic tumors in 32 patients. There were no treatment- related death. Two complications related with RFA treatment, one intrahepatic bleeding and one intrahepatic abscess, occurred in 41 sessions of RFA (6.2%). With a median follow-up of 13.5 months, tumors recurred in 7 of 70 lesions (10.0%) from 5 patients due to incomplete necrosis and intrahepatic new lesion or distant metastasis in 13 patients of 27 patients (51.9%) after complete necrosis. There were 5 deaths and the 2 year survival rate was 80.9%. Disease free survival was 90.1%, 75%, 26.4% in 6 months, 12 months and 24 months, respectively. Seven patients underwent liver resections successfully with the application of RFA for the residual lesions in the remaining contralateral lobe. In these patients, with 9.0 months median follow up, the disease recurred in 2 patients due to incomplete necrosis, while recurring in 2 patients after complete necrosis and 3 patients were survived without recurrence or distant metastasis.
CONCLUSIONS
Radiofrequency ablation is a safe, well-tolerated, and effective treatment for liver metastasis in colorectal cancer patients. The procedure can be used to treat the residual tumor load in the contralateral lobe following liver resection in those considered unresectable at first presentation. This new therapeutic strategy seems to increase surgical resectability in patients whose mass is determined unresectable. To approve the efficacy of RFA, more long- term follow up should be attempted.

Management of Colorectal Cancer Liver Metastasis.: Hwang, Dae Yong; J Korean Soc Coloproctol. 2000;16(1):47-56.

1,320 View
11 Download

Abstract PDF: The liver is the predominant metastatic site of colorectal cancer. When the patients general condition, the absence of extrahepatic metastases, number and locations of hepatic lesions permit, hepatic resection may be curative and should be considered standard therapy. Regional approaches, such as cryotherapy, alcohol injection, radiation therapy, interstitial laser therapy, and chemoembolization even that may bring about effective palliation suggest experimental approaches to the treatment of hepatic metastases. Regional infusion of chemotherapeutic agent via hepatic artery has shown a great tumor response, but further studies are needed for evaluation of precise benefit of this approach. Manipulation of the gene level was recently possible and addressed for the treatment of unresectable hepatic metastases, but still many problems to overcome are remained for the effective delivery and selective expression of the therapeutic gene or gene product to the target cells. Thus, new approaches to the colorectal cancer liver metastases are clearly warranted.

First
Prev
Page of 1
Next
Last

Search