Clinical and translational studies on recurrence of colorectal liver metastases.

Hof, J. (Joost) (2015) Clinical and translational studies on recurrence of colorectal liver metastases. thesis, Medicine.

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Abstract

Background Surgical resection (golden standard) and minimal invasive options (radiofrequency ablation, RFA) are the only curative treatment options for colorectal liver metastases (CRLM). Approximately 35-40% of the patients can be permanently cured with these treatments. Many patients are treated with adjuvant chemotherapy after liver surgery for CRLM to eradicate micro-metastases. However, chemotherapy is not proven to be a beneficial treatment. Aim and Methods A database including 431 patients undergoing 707 procedures for metastatic colorectal cancer was analyzed to make a reliable risk assessment on recurrence of disease and survival. Additionally, we want to identify patients who will not benefit from chemotherapy and are cured with only surgery. Therefore, resected frozen tumor samples of 40 patients with different survival rates were selected out of this database to measure gene expression. Results RFA substantially increased the number of patients that can be treated with curative intent for recurrent CRLM showing similar survival rates compared to surgical resection. Multivariate analysis showed that the ‘Fong clinical risk score’ is an accurate predictor of survival. The ‘genetic signature’ associated with long-term survival and therefore an indication for not undergoing chemotherapy is yet to be determined. Conclusions Surgical resection has similar results compared to RFA, for both treating the initial CRLM and recurrences. More data-analysis and molecular experiments have to be performed to draw honest conclusions from the genetic signature.

Item Type:	Thesis (Thesis)
Supervisor name:	Jong, Dr. K.P. de and Kok, Dr. K.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:55
Last Modified:	25 Jun 2020 10:55
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1556

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