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. 2023 Apr 13;85(5):1413-1419.
doi: 10.1097/MS9.0000000000000619. eCollection 2023 May.

Twenty-year experience in liver surgery in metastatic colorectal patients: a case series study in Ukraine

Anton Burlaka  1 , Anton Ryzhov  2 , Yurii Ostapenko  3 , Natalia Bankovska  4 , Kostiantyn Kopchak  5 , Vitalii Zvirych  1 , Tetiana Golovko  6 , Andriy Shypko  7 , Andrii Lukashenko  7
Affiliations

Twenty-year experience in liver surgery in metastatic colorectal patients: a case series study in Ukraine

Anton Burlaka et al. Ann Med Surg (Lond). .

Abstract

For the last three decades, the world surgical community successfully adopted different surgical strategies for colorectal cancer (CRC) patients with liver metastases (LM), however, we are still seeing the evolution of treatment guidelines. The purpose of the study was to analyze a 20-year evolution of CRC patients with LM being treated in a specialized state Ukrainian oncological center.

Materials and methods: The retrospective analysis of 1118 CRC patient cases using prospectively collected patient data from the National Cancer Institute registry. The time ranges between 2000-2010 and 2011-2022 and the LM manifestation - metachronous (M0)/synchronous (M1) were the two main grouping criteria.

Results: The overall survival 5-year survival of patients who had surgery between 2000-2011 and 2012-2022 was 51.3 and 58.2% (P=0.61) for the M0 cohort and 22.6 and 34.7% at M1 (P=0.002), respectively. The results of the multivariate analysis in 1118 cases revealed that liver re-resection and regional lymph node dissection ≥D2 were associated with better overall survival [hazard ratio (95% CI)=0.76 (0.58-0.99) P=0.04] in the M0 cohort and receiving at least 15 courses of chemotherapy had better recurrence-free survival rates [hazard ratio (95% CI)=0.97 (0.95-0.99), P=0.03] for both M0 and M1.

Conclusions: It was shown the improvement of the oncological prognosis for CRC patients with synchronous LM who were treated after 2012. The adaptation of world experience algorithms and the surgical strategy evolution have become the root cause of the above.

Keywords: case series; colorectal cancer; liver metastases; liver resection; parenchyma sparing.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The experience curve of open and LLRs in patients with colorectal cancer. *Performed more than 50 open interventions per year. **Performed more than 35 LLR per year. LLR, laparoscopic liver resection; LR, liver resection.
Figure 2
Figure 2
The overall survival (OS) and recurrence-free survival (RFS) of 1118 patients with colorectal cancer. Where ‘M0’ and ‘M1’ are patients with metachronous and synchronous liver metastasis, respectively; ‘S(M1)’ – cohort of patients with synchronous metastasis who received only surgical treatment; ‘S+CTx (M1)’ – cohort of patients with synchronous metastasis who received surgical treatment and CTx; ‘M1 (2000–2011)’ and ‘M1 (2012–2022)’ – cohorts of patients with synchronous metastasis who were treated in the corresponding time intervals. *A vertical dashed line in the graph represents the 5-year survival rate.
See this image and copyright information in PMC

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