- Case Study of a 33-Year-Old With Metastatic Colorectal Cancer
Resection of primary and liver lesions may be the optimal control over Stage IV rectal cancer with liver metastases. For patients with extensive liver metastases, FOLFOX and FOLFIRI have improved resection rates and survival. We compared survival outcomes in patients with Stage IV rectal cancer with liver metastases undergoing staged or synchronous resection with individuals undergoing primary rectal resection only or no resection whatsoever.
Patients with metastatic rectal cancer to liver were identified from the colorectal cancer database from 2002 to 2008. Patients received neoadjuvant chemoradiation and adjuvant FOLFOX or FOLFIRI therapy. The final results for patients who went through synchronous resection, staged resection, resection of rectal tumor only, with no resection with chemotherapy only were compared. Record analysis was resolute by ANOVA. Survival was resolute while using Kaplan-Meier method.
70-four patients were identified: 30 synchronous resections, 13 staged resections, 22 primary resection only, and 9 no resection. Median follow-up was 23 several weeks (range = 4-58 several weeks). 60-5 % of patients went through liver resection with 26% made qualified for resection after adjuvant therapy. Individuals who went through primary resection only had shorter median survival than individuals who went through either staged or synchronous liver resection (31 versus. 47 versus. 46 several weeks, correspondingly P = .17). Survival wasn’t any different for synchronous versus staged resection (P = .6). Amount of liver disease predicted resectability (P = .001). Without liver resection, 2-year survival was roughly 60%. Palliative surgery was needed in six of nine patients who didn’t undergo resection of the primary tumor.
Current chemotherapeutic regimens result in improved survival in patients with unresectable liver metastases. Upfront chemotherapy within the asymptomatic patient in contrast to resection from the primary tumor doesn’t seem to considerably affect survival. However, considering that 60% of patients were alive after 24 months, resection from the primary lesion for palliative reasons and native control should be considered.