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EP01A-065 Liver directed therapies in management of colorectal liver metastasis (crlm): experience from tata memorial centre

In HPB : the official Journal of the International Hepato Pancreato Biliary Association
By: Patkar S.
Contributor(s): Goel M | Patil S | Shetty N | Chaudhari V | Bhandare M | Mitra A | Ostwal V | Sirohi B | de Souuza A | Shrikhande SV.
Material type: materialTypeLabelArticlePublisher: Oxford, UK : Elsevier, 2015Description: .Subject(s): CRLMOnline resources: PDF In: HPB : the official Journal of the International Hepato Pancreato Biliary Association Vol. 18, Supp.1, p. e185Summary: Introduction: Data from Asia Pacific region on liver directed therapies in management of Colorectal liver metastasis (CRLM) is sparse. Methods: Prospective database over a period of 5 years was analyzed retrospectively (November 2009eJune 2015). Patients offered liver directed therapy i.e. surgery, radiofrequency ablation (RFA), transarterial chemo (TACE)/radio-embolisation (TARE) were included. Results: Total of 134 patients of liver directed therapies were included in this study with a mean age of 52 years. (94 males, 40 females), Surgery alone was performed in 46 patients, Surgery + RFA in 9, Surgery + TACE in 3 and Surgery + RFA and TACE in 3. RFA was performed in 61 (along with TACE in 17 and TARE in 2) and only TARE in 12 patients. Synchronous resection of the primary and liver lesion was performed in 8 patients. 34 patients received systemic chemotherapy prior to resection. Major postoperative morbidity was 10% with one mortality. Postoperative liver insufficiency and bile leaks occurred in 2.17% and 4.3% respectively. 51/61 (83.6%) patients who underwent RFA had complete ablation while 10 underwent either TACE or repeat RFA for residual lesion. 40 patients had complete response after 6 weeks treatment while 8 patients had lesion recurrence. 2 underwent TARE for disease progression. At a median follow up of 19 months, the overall survival was 33 months and progression free survival 9 months. Conclusion: CRLM are being increasingly diagnosed. Our series highlights the emerging role of multidisciplinary care in management of CRLM in the Indian subcontinent.
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Published in Electronic Poster Abstracts

Introduction: Data from Asia Pacific region on liver
directed therapies in management of Colorectal liver
metastasis (CRLM) is sparse.
Methods: Prospective database over a period of 5 years
was analyzed retrospectively (November 2009eJune
2015). Patients offered liver directed therapy i.e. surgery,
radiofrequency ablation (RFA), transarterial chemo
(TACE)/radio-embolisation (TARE) were included.
Results: Total of 134 patients of liver directed therapies
were included in this study with a mean age of 52 years. (94
males, 40 females), Surgery alone was performed in 46
patients, Surgery + RFA in 9, Surgery + TACE in 3 and
Surgery + RFA and TACE in 3. RFA was performed in 61
(along with TACE in 17 and TARE in 2) and only TARE in
12 patients. Synchronous resection of the primary and liver lesion was performed in 8 patients. 34 patients received
systemic chemotherapy prior to resection. Major postoperative
morbidity was 10% with one mortality. Postoperative
liver insufficiency and bile leaks occurred in
2.17% and 4.3% respectively. 51/61 (83.6%) patients who
underwent RFA had complete ablation while 10 underwent
either TACE or repeat RFA for residual lesion. 40 patients
had complete response after 6 weeks treatment while 8
patients had lesion recurrence. 2 underwent TARE for
disease progression. At a median follow up of 19 months,
the overall survival was 33 months and progression free
survival 9 months.
Conclusion: CRLM are being increasingly diagnosed. Our
series highlights the emerging role of multidisciplinary care
in management of CRLM in the Indian subcontinent.

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