Introduction:
A recent study explored the role of debulking hepatectomy in patients with unresectable colorectal liver metastasis (CRLM). The aim was to identify risk factors affecting progression-free survival (PFS) and evaluate the feasibility and benefits of such an approach.
Study Details:
Population: Patients with advanced CRLM undergoing either curative intent hepatectomy or debulking hepatectomy.
Methodology: Comparison of outcomes, including overall survival (OS) and PFS, between two groups:
Group I: Resectable disease treated with curative intent.
Group II: Incompletely resectable disease treated with debulking hepatectomy.
Results:
No significant difference in intra-operative and post-operative outcomes between the groups.
OS Rates: 3-year OS was 69% for Group I and 64% for Group II; 5-year OS was 47% for Group I and 35% for Group II.
PFS Rates: 3-year PFS was 32% for Group I and 12% for Group II; 5-year PFS was 21% for Group I and 8% for Group II.
Independent predictors of lower PFS in the debulking group included bilobar metastases (HR=2.70), presence of extrahepatic metastasis (HR=2.65), and more than 9 metastases (HR=2.37).
Iterative liver surgery for CRLM was found to be a protective factor (HR=0.34).
Conclusion:
Aggressive debulking surgery may offer a survival benefit for selected patients with unresectable CRLM without increasing morbidity. The decision for surgery should be individualized based on patient-specific factors.
Read the full study here
https://doi.org/10.1016/j.suronc.2024.102056
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