Abstract
Objective: to evaluate feasibility and short-term results of the liver-first approach in our center.Materials and methods. Retrospective study of prospectively gathered group of patients who were treated in N. N. Blokhin National Medical Research Center of Oncology between 2017 and 2019. Patients with asymptomatic primary tumor located in rectum and rectosigmoid junction with synchronous resectable / borderline resectable metastasis in liver. 22 patients were planned to undergo the liver-first approach. Post-operative morbidity and mortality (Clavien–Dindo) as well as tumor regression grading (Dworak) were evaluated.Results. Of the 17 patients planned to undergo the liver-first strategy, the approach was completed in 15 (88,2 %) patients. The main reason for treatment failure was disease progression. Post-operative morbidity and mortality were 13,3 % and 0 %, respectively.Conclusions. Liver-first approach is justified in two cases: during waiting period after last day of chemoradiotherapy in patients with locally advanced (invasion depth T4a, positive circumferential resection margin, N+ status) mid-to-low rectal cancer and in patients with multiple borderline resectable bilobar liver damage.
Highlights
Цель исследования – оценка непосредственных результатов лечения больных метастатическим раком прямой кишки, в отношении которых была использована тактика «сначала печень»
Patients with asymptomatic primary tumor located in rectum and rectosigmoid junction with synchronous resectable / borderline resectable metastasis in liver. 22 patients were planned to undergo the liver-first approach
Liver-first approach is justified in two cases: during waiting period after last day of chemoradiotherapy in patients with locally advanced mid-to-low rectal cancer and in patients with multiple borderline resectable bilobar liver damage
Summary
Цель исследования – оценка непосредственных результатов лечения больных метастатическим раком прямой кишки, в отношении которых была использована тактика «сначала печень». Тактика «сначала печень» при лечении пациентов с синхронными метастазами рака прямой кишки в печени. Материалы и методы циенты (87 %) с местно-распространенным характером роста первичной опухоли с глубиной инвазии T4a, Проведено ретроспективное исследование про- также зафиксирована высокая частота билобарного спективно набранной группы пациентов с метастати- поражения печени (93 % случаев). У 4 (36,5 %) пацическим КРР, пролеченных в ФГБУ «Национальный ентов из 11 первичная опухоль локализовалась в верхмедицинский исследовательский центр онкологии неампулярном отделе прямой кишки, у 4 (36,5 %) –.
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