Degenaar, K.J. (2015) De uitkomst van de Liver First Approach bij colorectale levermetastasen in het Medisch Spectrum Twente. thesis, Medicine.
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Abstract
Background: Synchronous colorectal liver metastasis (CRLM) are present in 25-30% of the patients with colorectal carcinoma (CRC). These patients qualify for a reversed strategy of the classical treatment: the Liver First Approach (LFA). Today, there are a small number of studies which report about the LFA for CRLM. The intent of this study is to analyse the results of the LFA in the Medisch Spectrum Twente and compare them to the known literature. Methods: This study concerns a retrospective cohort study. Between 2008 and 2014, 32 out of 100 liver resections were performed according to a LFA. Collected data from our database which contains all 344 patients who underwent liver surgery between 1997 and present and includes patient characteristics, operation details and follow-up with survival. Results: 32 patients with synchronous CRLM (16 men, median age 62 years) of which 26 had a rectal primary and 6 patients a colon carcinoma, were planned for a LFA. 19 patients received neoadjuvant chemotherapy. 23 (89%) of the 26 patients with a rectum primary received neoadjuvant radiotherapy. 31 patients underwent liver resection, in which the post-operative morbidity and mortality rates were respectively 22% and 0%. The post-operative morbidity and mortality of the 20 patients who underwent a resection of the primary tumour were 55% and 0%. Of the 32 patients planned for a LFA, 21 completed the full treatment (68%). The main reason for treatment failure was disease progression. The median time to disease progression for the whole group was 9 months. 1- and 3-year survival rates were respectively 81% and 56% for the whole group. Conclusion: The LFA is feasible, when applied to the right population. The results of the Medisch Spectrum Twente are comparable to the known literature and the classical approach for CRLM. One-third of the patients does not complete the protocol because of disease progression.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Klaase, Dr. J. M. and Heelkunde and Medisch Spectrum Twente, Enschede |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:38 |
| Last Modified: | 25 Jun 2020 10:38 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/29 |
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