Publicaciones científicas
Feasibility and Short-Term Outcomes in Liver-First Approach: A Spanish Snapshot Study (the RENACI Project)
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.
CITA DEL ARTÍCULO Cancers (Basel). 2024 Apr 26;16(9):1676. doi: 10.3390/cancers16091676
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