Interdisciplinary Approach in Treatment of Primary Unresectable Liver Metastases of Colorectal Cancer: 8.5 Years Follow-up

Abstract

Background: The aim of the study was to explore the effectiveness of the interdisciplinary approach in the treatment of primary unresectable liver metastasis of colorectal cancer (mCRC). Methods: Treatment results of 192 patients with mCRC were included in the retrospective analysis. Strategy of treatment were developed due to the interdisciplinary approach of oncosurgery, medical oncologist and intervention radiologist. Patients characteristics: mean age 55.9 ± 12.2 years, primary tumors - colon/rectum 149/43, number of metastases 5.1 ± 2.8. All patients underwent neoadjuvant chemotherapy (FOLFOX, FOLFIRI) 3-9 course (an average 4 courses), 11 patients additionally intra-arterial chemoembolization (an average 2 courses), 97 (50.5 %) patients liver resection combined with RFA, 11 (5.7 %) patients - two-stage hepatectomy. Results: Tumor response after a first-line chemotherapy gave possibility to perform a resection in 154 (80.2 %) of patients, 38 (19.8 %) had held the second line chemotherapy, which was combined with embolization in 14 (7.3 %) patients. 3-, 5- and 8.5-year survival rates were 51%, 36.2 % and 26.3%, respectively. The median survival was 47 months. Median follow-up was 51.6 months (12-90). Conclusion: The interdisciplinary approach in treatment of primary unresectable hepatic colorectal cancer metastases increased the 8.5-year survival rate till 26.3%.