Combined clinical and surgical strategies for advanced colorectal cancer with hepatic metastases: impact on survival and quality of life-a systematic review

Guillermo Olaya Villarreal; Camila Montes Castellanos; Mariant Karolyn Bolívar Sánchez; Jorge Luis Rivera Gastelum; David Bernardo García Noriega; Mauricio Zuluaga Zuluaga; Jose Carlos Ordosgoitia Mora; Alfonso Joan Massé Ponce

doi:10.18203/2320-6012.ijrms20243723

Authors

Guillermo Olaya Villarreal Internal Medicine Department, Universidad De Cartagena, Colombia
Camila Montes Castellanos Internal Medicine Department, Universidad Nacional Autónoma de México, México
Mariant Karolyn Bolívar Sánchez Emergency Department, Hospital San Juan de Dios, Chile
Jorge Luis Rivera Gastelum General Surgery Department, Independent Investigator, México
David Bernardo García Noriega Medical Department, Zacatecas Halth Secretariat, Mexico
Mauricio Zuluaga Zuluaga General Surgery, Universidad del Valle Cali Colombia; Hospital Universitario del Valle; Clínica de Occidente; Clínica Sebastián de Belalcazar Colsanitas, Columbia
Jose Carlos Ordosgoitia Mora Medical Department, Universidad Del Sinu, Colombia
Alfonso Joan Massé Ponce Medical Department, Instituto Mexicano del Seguro Social (IMSS), México

DOI:

https://doi.org/10.18203/2320-6012.ijrms20243723

Keywords:

Colorectal neoplasms/therapy, Liver neoplasms/secondary, Neoadjuvant therapy/methods, Survival rate/statistics and numerical data, Quality of life/psychology

Abstract

We aim to evaluate in this systematic review the impact of combined clinical and surgical strategies on survival and quality of life in patients with advanced colorectal cancer and hepatic metastases (CRLM). We designed and followed our search on PubMed, Cochrane Library, Embase, and Google Scholar for studies published between 2010 and 2024. Inclusion criteria encompassed studies reporting survival rates and quality of life outcomes in patients who went through clinical or surgical management for CRLM and our data extraction and quality assessment were performed using standardized tools and risk of bias of included RCTs was accessed using Cochrane risk of bias tool. We found liver-first approach demonstrated improved 3-year overall survival (69%) for synchronous CRLM compared to combined or classic approaches with 54.4–60.4%. Neoadjuvant chemotherapy facilitated tumor downstaging but was associated with liver injury when prolonged beyond five cycles and those patients with metachronous CRLM, surgical resection come with maximum survival rate with five-year survival rates reaching 60% in selected cases and quality of life outcomes was improved in patients achieving curative resection. After all research, it can be can conclude that combined clinical and surgical strategies and tailored sequencing of treatment can enhance survival and quality of life for CRLM patients. Early multidisciplinary interventions and optimized chemotherapy regimens are critical in balancing oncologic outcomes and treatment-related risks.

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References

Marcellinaro R, Spoletini D, Grieco M, Avella P, Cappuccio M, Troiano R, et al. Colorectal cancer: current updates and future perspectives. J Clin Med. 2023;13(1):40.

Siegel R.L., Miller K.D., Fuchs H.E., Jemal A. Cancer statistics, 2022. CA Cancer J. Clin. 2022;72:7–33.

Martin J, Petrillo A, Smyth EC, Shaida N, Khwaja S, Cheow HK, et al. Colorectal liver metastases: Current management and future perspectives. World J Clin Oncol. 2020;11(10):761–808.

Home - Journal of Gastrointestinal Oncology [Internet]. https://jgo.amegroups.org. Available from: https://jgo.amegroups.org/

Lintoiu-Ursut B, Tulin A, Constantinoiu S. Recurrence after hepatic resection in colorectal cancer liver metastasis. 2015. Available at: https://pmc.ncbi.nlm.nih. Acessed on 21 September.

Line PD, Hagness M, Dueland S. Liver Transplantation for CRLM—Is It ever indicated. Colorectal cancer liver metastases: a comprehensive guide to management. 2020:531-46.

Vadisetti SN, Kazi M, Patkar S, Mundhada R, Desouza A, Saklani A, et al. Patterns and predictors of recurrence after curative resection of colorectal liver metastasis (CRLM). J Gastrointes Can. 2024;55(4):1559-68.

Creasy JM, Sadot E, Koerkamp BG, Chou JF, Gonen M, Kemeny NE, et al. Actual 10-year survival after hepatic resection of colorectal liver metastases: What factors preclude cure? Surgery. 2018;163:1238–44.

Sa Cunha A, Laurent C, Rault A, Couderc P, Rullier E, Saric J. A second liver resection due to recurrent colorectal liver metastases. Arch Surg. 2007;142:1144–9.

Khan AS, Garcia-Aroz S, Ansari MA, Atiq SM, Senter-Zapata M, Fowler K, et al. Assessment and optimization of liver volume before major hepatic resection: Current guidelines and a narrative review. Int J Surg. 2018;52:74–81.

Choi SH, Kim SY, Park SH, Kim KW, Lee JY, Lee SS, Lee MG. Diagnostic performance of CT, gadoxetate disodium-enhanced MRI, and PET/CT for the diagnosis of colorectal liver metastasis: Systematic review and meta-analysis. J Magn Reson Imaging. 2018;47:1237–1250.

Villard C, Habib M, Nordenvall C, Nilsson PJ, Jorns C, Sparrelid E. Conversion therapy in patients with colorectal liver metastases. Eur J Surg Oncol. 2021;47:2038-45.

Ivey GD, Johnston FM, Azad NS, Christenson ES, Lafaro KJ, Shubert CR. Current surgical management strategies for colorectal cancer liver metastases. Cancers. 2022;14(4):1063.

Wisneski AD, Jin C, Huang CY, Warren R, Hirose K, Nakakura EK, Corvera CU. Synchronous versus metachronous colorectal liver metastasis yields similar survival in modern era. J Surg Res. 2020;256: 476–85.

Giuliante F, Vigano L, De Rose AM, Mirza DF, Lapointe R, Kaiser G, et al. Liver-first approach for synchronous colorectal metastases: analysis of 7360 patients from the liver met survey registry. Ann Surg Oncol. 2021;28:8198–208.

Gangi A, Lu SC. Chemotherapy-associated liver injury in colorectal cancer. Therap Adv Gastroenterol. 2020;13:24194.

Nordlinger B, Sorbye H, Glimelius B, Poston GJ, Schlag PM, Rougier P, et al. Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): A randomised controlled trial. Lancet. 2008;371:1007–16.

Moris D, Ronnekleiv-Kelly S, Rahnemai-Azar AA, Felekouras E, Dillhoff M, Schmidt C, et al. Parenchymal-sparing versus anatomic liver resection for colorectal liver metastases: a systematic review. J Gastroint Surg. 2017;21(6):1076-85.

Alvarez FA, Claria RS, Oggero S, de Santibañes E. Parenchymal-sparing liver surgery in patients with colorectal carcinoma liver metastases. World journal of gastrointestinal surgery. 2016;8(6):407.

Andreou A, Gloor S, Inglin J, Martinelli CD, Banz V, Lachenmayer A, et al. Parenchymal-sparing hepatectomy for colorectal liver metastases reduces postoperative morbidity while maintaining equivalent oncologic outcomes compared to non-parenchymal-sparing resection. Surgical oncology. 2021;38:101631.

Kambakamba P, Hoti E, Cremen S, Braun F, Becker T, Linecker M. The evolution of surgery for colorectal liver metastases: A persistent challenge to improve survival. Surgery. 2021 Dec 1;170(6):1732-40.

Calderon Novoa F, Ardiles V, de Santibañes E, Pekolj J, Goransky J, Mazza O, et al. Pushing the limits of surgical resection in colorectal liver metastasis: how far can we go. Cancers. 2023;15(7):2113.

Koopman M, Venderbosch S, van Tinteren H, Ligtenberg MJ, Nagtegaal I, Van Krieken JH, et al. Predictive and prognostic markers for the outcome of chemotherapy in advanced colorectal cancer, a retrospective analysis of the phase III randomised CAIRO study. European J Can. 2009;45(11):1999-2006.

Kanemitsu Y, Shitara K, Mizusawa J, Hamaguchi T, Shida D, Komori K, et al. A randomized phase III trial comparing primary tumor resection plus chemotherapy with chemotherapy alone in incurable stage IV colorectal cancer: JCOG1007 study (iPACS).

Leal F, Ferreira FP, Sasse AD. FOLFOXIRI regimen for metastatic colorectal cancer: a systematic review and meta-analysis. Clinical colorectal cancer. 2017;16(4):405-9.

Adam R, Piedvache C, Chiche L, Adam JP, Salamé E, Bucur P, et al. Liver transplantation plus chemotherapy versus chemotherapy alone in patients with permanently unresectable colorectal liver metastases (TransMet): results from a multicentre, open-label, prospective, randomised controlled trial. Lancet. 2024;404(10458):1107-18.

O’Connell RM, Hoti E. Challenges and opportunities for precision surgery for colorectal liver metastases. Cancers. 2024;16(13):2379.

Martin JK. Prathap memorial lecture: exploring advances and the potential of disruptive technologies in pathology and laboratory medicine. Malays J Pathol. 2021;43(1):113-92.

Chehimi M, Delort L, Vidal H, Caldefie-Chezet F, Eljaafari A. Contribution of adipose stem cells from obese subjects to hepato-or breast-carcinoma tumorogenesis, through promotion of Th17 cells. InForum de la Recherche en Cancérologie Rhône-Alpes Auvergne. 2017;2:147.

Jia J, Wu X, Long G, Yu J, He W, Zhang H, et al. Revolutionizing cancer treatment: Nanotechnology-enabled photodynamic therapy and immunotherapy with advanced photosensitizers. Frontiers in Immunology. 2023;14:1219785.

Haque M, Shakil MS, Mahmud KM. The promise of nanoparticles-based radiotherapy in cancer treatment. Cancers. 2023;15(6):1892.

Koka K, Verma A, Dwarakanath BS, Papineni RV. Technological advancements in external beam radiation therapy (EBRT): An indispensable tool for cancer treatment. Cancer Manag and Res. 2022:1421-9.