Preview

Acta Biomedica Scientifica

Advanced search

Combination of chemoembolization with hepatic resection and methods of local destruction in complex treatment of colorectal cancer

https://doi.org/10.12737/article_59f035f8bc7ad1.15216742

Abstract

The aim of the study was to prove the efficacy of the treatment regimen for patients with colorectal cancer with metastatic liver involvement. The regimen included a combination of colon and liver resection, methods of local destruction and chemotherapy. There were 126 patients with colon cancer and metastases in the liver involved in the study. All tumors were adenocarcinomas of the intestinal type. Metastases in the liver affected both lobes of the liver. In the main group (64 patients), resection of the large intestine and liver resection were carried out. During the operation, radiofrequency ablation of the remaining metastases and chemoembolization of the portal vein were performed. In the postoperative period, systemic chemotherapy and chemoembolization of the hepatic artery were prescribed. In the control group (62 patients), surgery was performed on the large intestine and systemic chemotherapy was performed. Complications of the operation occurred in 18 patients (28.1 %) in the main group and 10 in patients (16.1 %) in the control group (p = 0.004). Median disease-free survival in the main group was 9.01 months, in the control group - 5.01 months (p = 0.001). Median overall survival in the main group was 13.8 months, in the control group - 9.8 months (p = 0.004). One-year overall survival in the main group was 60.93 %, in the control group - 41.93 %, two-year in the main group -17.18 %, in the control group - 6.45 %. In the control group, there were no three years survivals, and in the main group, the three-year overall survival was 4.68 %.

About the Authors

A. S. Zagainov
Irkutsk State Medical Academy of Postgraduate Education - Branch Campus of the Russian Medical Academy of Continuing Professional Education
Russian Federation


R. I. Rasulov
Irkutsk State Medical Academy of Postgraduate Education - Branch Campus of the Russian Medical Academy of Continuing Professional Education
Russian Federation


A. V. Shelekhov
Irkutsk State Medical Academy of Postgraduate Education - Branch Campus of the Russian Medical Academy of Continuing Professional Education
Russian Federation


R. A. Zubkov
Irkutsk State Medical Academy of Postgraduate Education - Branch Campus of the Russian Medical Academy of Continuing Professional Education
Russian Federation


V. V. Dvornichenko
Irkutsk State Medical Academy of Postgraduate Education - Branch Campus of the Russian Medical Academy of Continuing Professional Education
Russian Federation


References

1. Таразов П.Г., Гранов Д.А., Поликарпов А.А., Полысалов В.Н. Комбинированная химиоэмболизация печеночной артерии и воротной вены при метастазах колоректального рака в печень // Вопросы онкологии. - 2002. - Т. 48, № 1. - С. 83-87

2. Aslam M.I., Kelkar A., Sharpe D., Jameson J.S. / (2010). Ten years experience of managing the primary tumours in patients with stage IV colorectal cancers. Int. J. Surg., 8, 305-313.

3. Birth M., Hildebrand P., Dahmen G., Ziegler A., Broring D.C., Hillert C., Bruch H.P. (2004). Present state of radio frequency ablation of liver tumors in Germany. Chirurg, 75, 417-423.

4. Brenner H., Kloor M., Pox C.P. (2014). Colorectal cancer. Lancet, 383 (9927), 1490-1502. doi: 10.1016/S0140-6736(13)61649-9.

5. Chua T.C., Saxena A., Liauw W., Kokandi A., Morris D.L. (2010). Systematic review of randomized and nonrandomized trials of the clinical response and outcomes of neoadjuvant systemic chemotherapy for resectable colorectal liver metastases. Ann. Surg. Oncol., 17, 492-501.

6. Figueras J., Torras J., Valls C., Llado L., Ramos E., Marti-Rague J., Serrano T., Fabregat J. (2007). Surgical resection of colorectal liver metastases in patients with expanded indications: a single-center experience with 501 patients. Dis. Colon. Rectum, 50, 478-488.

7. Gonsalves C.F., Brown D.B. (2009). Chemo-embolization of hepatic malignancy. Abdom. Imaging, 34, 557-565.

8. Haugeberg G., Strohmeyer Т., Lierse W., Bocker W. (1988). The vascularization of liver metastases. Histological investigation of gelatine-injected liver specimens with special regard to the vascularization of micrometastases. J. Cancer. Res. Clin. Oncol., 14 (4), 415419.

9. Martin R.C., Joshi J.K., Robbins K., Tomalty D., Bosnjakovik P., Derner M., Padr R., Rocek M., Scupchenko A., Tatum C. (2011). Hepatic intra-arterial injection of drug-eluting bead, irinotecan (DEBIRI), in unresectable colorectal liver metastases refractory to systemic chemotherapy: results of multiinstitutional study. Ann. Surg. Oncol., 18 (1), 192-198.

10. Mulier S., Mulier P., Ni Y., Miao Y., Dupas B., Marchal G., De Wever I., Michel L. (2002). Complications of radiofrequence coagulation of liver tumours. Br. J. Surg., 176, 3-16.

11. Solbiati L., Ahmed M., Cova L., Ierace T., Brioschi M., Goldberg S.N. (2012). Small liver colorectal metastases treated with percutaneous radiofrequency ablation: local response rate and long-term survival with up to 10-year follow-up. Radiology, 265 (3), 958-968.

12. Stelzner S., Hellmich G., Koch R., Ludwig K. (2005). Factors predicting survival in stage IV colorectal carcinoma patients after palliative treatment: a multivariate analysis. J. Surg. Oncol., 89, 211-217.


Review

For citations:


Zagainov A.S., Rasulov R.I., Shelekhov A.V., Zubkov R.A., Dvornichenko V.V. Combination of chemoembolization with hepatic resection and methods of local destruction in complex treatment of colorectal cancer. Acta Biomedica Scientifica. 2017;2(3):14-17. (In Russ.) https://doi.org/10.12737/article_59f035f8bc7ad1.15216742

Views: 564


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2541-9420 (Print)
ISSN 2587-9596 (Online)