Scientific publications

Feasibility and Short-Term Outcomes in Liver-First Approach: A Spanish Snapshot Study (the RENACI Project). Scientific Publication

Apr 26, 2024 | Magazine: Cancers

Mario Serradilla-Martín  1   2   3 , Celia Villodre  4   5   6 , Laia Falgueras-Verdaguer  7 , Natalia Zambudio-Carroll  1 , José T Castell-Gómez  8 , Juan L Blas-Laina  9 , Vicente Borrego-Estella  10 , Carlos Domingo-Del-Pozo  11 , Gabriel García-Plaza  12 , Francisco J González-Rodríguez  13 , Eva M Montalvá-Orón  14 , Ángel Moya-Herraiz  15 , Sandra Paterna-López  16 , Miguel A Suárez-Muñoz  17 , Maialen Alkorta-Zuloaga  18 , Gerardo Blanco-Fernández  19 , Enrique Dabán-Collado  20 , Miguel A Gómez-Bravo  21 , José I Miota-de-Llamas  22 , Fernando Rotellar  23 , Belinda Sánchez-Pérez  24 , Santiago Sánchez-Cabús  25 , David Pacheco-Sánchez  26 , Juan C Rodríguez-Sanjuan  27 , María A Varona-Bosque  28 , Lucía Carrión-Álvarez  29 , Sofía de la Serna-Esteban  30 , Cristina Dopazo  31 , Elena Martín-Pérez  32 , David Martínez-Cecilia  32   33 , María J Castro-Santiago  34 , Dimitri Dorcaratto  35 , Marta L Gutiérrez-Díaz  36 , José M Asencio-Pascual  37 , Fernando Burdío-Pinilla  38 , Roberto Carracedo-Iglesias  39 , Alfredo Escartín-Arias  40 , Benedetto Ielpo  38   41 , Gonzalo Rodríguez-Laiz  4 , Andrés Valdivieso-López  42 , Emilio De-Vicente-López  43 , Vicente Alonso-Orduña  44 , José M Ramia  4   5   6


Abstract

(1) Background: The liver-first approach may be indicated for colorectal cancer patients with synchronous liver metastases to whom preoperative chemotherapy opens a potential window in which liver resection may be undertaken. This study aims to present the data of feasibility and short-term outcomes in the liver-first approach.

(2) Methods: A prospective observational study was performed in Spanish hospitals that had a medium/high-volume of HPB surgeries from 1 June 2019 to 31 August 2020.

(3) Results: In total, 40 hospitals participated, including a total of 2288 hepatectomies, 1350 for colorectal liver metastases, 150 of them (11.1%) using the liver-first approach, 63 (42.0%) in hospitals performing <50 hepatectomies/year. The proportion of patients as ASA III was significantly higher in centers performing ≥50 hepatectomies/year (difference: 18.9%; p = 0.0213). In 81.1% of the cases, the primary tumor was in the rectum or sigmoid colon. In total, 40% of the patients underwent major hepatectomies. The surgical approach was open surgery in 87 (58.0%) patients. Resection margins were R0 in 78.5% of the patients. In total, 40 (26.7%) patients had complications after the liver resection and 36 (27.3%) had complications after the primary resection. One-hundred and thirty-two (89.3%) patients completed the therapeutic regime.

(4) Conclusions: There were no differences in the surgical outcomes between the centers performing <50 and ≥50 hepatectomies/year. Further analysis evaluating factors associated with clinical outcomes and determining the best candidates for this approach will be subsequently conducted.

CITATION  Cancers (Basel). 2024 Apr 26;16(9):1676. doi: 10.3390/cancers16091676