RESUMEN
BACKGROUND: Preliminary study results demonstrated parenchyma-sparing surgery (PSS) as an effective approach which allowed to remove colorectal cancer (CRC) metastatic lesions within the central liver cites and increased the probability of the liver re-resections. METHODS: The prospective analysis re-evaluation of the 185 CRC patients surgical treatment has been performed. RESULTS: An overall 5-year survival (OS) of the 185 enrolled patients was 43 ± 7%, and the mean and median value for OS was 48.7 ± 1.9% and 55.2 ± 5 (95% CI: 44.4-66.1) months. The 5-year OS for CRC patients whose metastatic lesions were predominantly located within peripheral and central liver segments was 56 ± 8% and 27 ± 9%, respectively (p = 0.08). A 5-year disease-free survival (DFS) rates of patients with peripheral and central liver cites metastatic lesions were 31 ± 7 % and 15 ± 7%, p = 0,12. And the DFS median was 34.2 and 46.5 months for R1v and R0 cohorts, respectively, p = 0.62. CONCLUSIONS: Parenchyma-sparing surgery should be a priority pathway for complex treatment of patients with deeply located lesions of the right liver lobe. TRIAL REGISTRATION: The study is registered in https://www.researchregistry.com/browse-the-registry#home/registrationdetails/5ed9f60863e9bf0016624456/ , no. 5679.
Asunto(s)
Neoplasias Colorrectales , Neoplasias Hepáticas , Neoplasias Colorrectales/patología , Supervivencia sin Enfermedad , Hepatectomía/métodos , Humanos , Neoplasias Hepáticas/secundario , PronósticoRESUMEN
We present a rare case report of a bilateral avascular necrosis of lateral sacral masses in a patient who developed a sustainable complete clinical and radiological response after chemoradiotherapy for locally advanced rectal cancer. It is shown that despite the standardized and precise planning and fractioning for neoadjuvant chemoradiation therapy for locally advanced rectal cancer, the biological effects of ionizing radiation on critical organs can be va- ried both in time of occurrence and in structure. Evaluating the effect of neoadjuvant chemoradiation therapy, one should take into account the possibility of the development of even very rare effects of ionizing radiation on criti- cal organs and include their early detection in the diagnostic algorithm.
Asunto(s)
Adenocarcinoma/terapia , Quimioradioterapia/métodos , Necrosis/terapia , Terapia Neoadyuvante/métodos , Recurrencia Local de Neoplasia/terapia , Neoplasias del Recto/terapia , Adenocarcinoma/diagnóstico por imagen , Adenocarcinoma/patología , Anciano , Antineoplásicos/uso terapéutico , Humanos , Imagen por Resonancia Magnética , Masculino , Necrosis/diagnóstico por imagen , Necrosis/patología , Recurrencia Local de Neoplasia/diagnóstico por imagen , Recurrencia Local de Neoplasia/patología , Radiación Ionizante , Neoplasias del Recto/diagnóstico por imagen , Neoplasias del Recto/patología , Recto/diagnóstico por imagen , Recto/efectos de los fármacos , Recto/patología , Recto/efectos de la radiación , Inducción de Remisión , Sacro/diagnóstico por imagen , Sacro/efectos de los fármacos , Sacro/patología , Sacro/efectos de la radiación , Resultado del TratamientoRESUMEN
The results of treatment of 125 patients, suffering metastatic hepatic affection in colorectal cancer (pT1--4N0--2M1--in colonic cancer and pT1--3N0--2M1--in cancer recti), to whom in 2008-2015 yrs a one-staged (Group 1) or two-staged (Group II) surgical treatment was done. In affection of 4 regional lymph nodes and more (pN2) late results were less favorable, than in pN1 or pN0, not depending from surgical approach choosed. In 48 (38.4%) patients with one syndromal hepatic metastatic focus, the indices of general three-year and five-year cumulative survival were the best, than in other groups--82 and 63% (p = 0.001) accordingly; in monolobar affection--68 and 49%, and in bilobar--23 and 0%, not depending from method of surgical treatment (p < 0.001) choosed. Predictive factors were established, which impact negatively the indices of general survival in patients, suffering metastatic hepatic affection in colorectal cancer: hepatic metastatic foci number 4 and more, bilobar hepatic metastatic affection.