ABSTRACT
Oligometastasis is an intermediate status between the locally advanced and wide spread disease. Patients with oligometastasis may obtain long-term survival after local treatment. Stereotactic body radiation therapy (SBRT) can deliver radical ablative doses in a small number of fractions, which is a highly precise local ablation therapy. Approximately half of patients diagnosed with colorectal cancer (CRC) will develop metastases, with the liver and lung as the most common site of involvement. In this article, the safety, local efficacy and prognostic factors of SBRT for liver and lung oligometastases from CRC were illustrated. The highlights of SBRT implementation were also discussed. SBRT is safe and effective for oligometastases from CRC under respiratory motion management and robust quality assurance.
ABSTRACT
Liver is the most common metastatic site for colorectal cancer (CRC), there is no satisfied approach to treat CRC liver metastasis (CRCLM). Here, we investigated the role of a polycomb protein BMI-1 in CRCLM. Immunohistochemical analysis showed that BMI-1 expression in liver metastases was upregulated and associated with T4 stage, invasion depth and right-sided primary tumor. Knockdown
ABSTRACT
This study aims to investigate the value of pre-treatment computed tomography (CT) texture analysis in predicting therapeutic response of liver metastasis from colorectal cancer after combined targeting chemotherapy. A total of 82 patients with colorectal cancer liver metastases who underwent chemotherapy combined with targeted therapy (cetuximab) between March 2011 and October 2017 comprised this retrospective study population. According to the RECIST1.1, the best curative effect evaluation of patients was recorded. Complete response (CR) and partial response (PR) were assigned to the response group, and the stable disease (SD) and progressive disease (PD) were assigned to the non-response group. The CT texture analysis was based on the Omini-Kinetics software, and the three-dimensional (3D) texture analysis was performed on the marked lesion on portal phase. The differences of texture parameters between the response group and the non-response group were compared. The receiver operating characteristic (ROC) curves were depicted on the parameters which with statistically difference, to characterize value in predicting the response to target-combined chemotherapy. The differences of Entropy, Energy, Variance, std. Deviation, Quantile95 and sumEntropy between the two groups in pre-treatment lesions were significant ( 0.867, good diagnostic efficiency could be obtained, with sensitivity of 60.5% and specificity of 79.5%, respectively. In conclusion, texture parameters derived from baseline CT images of colorectal cancer liver metastasis have the potential value acting as imaging biomarkers in predicting tumor response to combined target chemotherapy.
ABSTRACT
Surgical resection is currently the only cure treatment for colorectal carcinoma liver metastasis (CRLM). The efficien-cy of surgical resection has improved with the development of systemic chemotherapy and targeted drugs and the application of hepatic arterial infusion chemotherapy in recent years. The number of patients benefiting from surgery has gradually increased. The progression of surgical techniques such as radiofrequency ablation and staged hepatectomy provides chances of cure for patients with CRLM. Multi-disciplinary team creates the opportunity of individual diagnosis and treatment for growing number of patients with CRLM, which, in turn, promotes the treatment of CRLM to a more precise future.
ABSTRACT
PUROPSE: The liver is a major site for the metastatic spread of primary colorectal cancers.. Among the various modalities of treatment for hepatic metastasis of colorectal cancer, hepatic resection has been proven to be the most effective treatment. This analysis was intended to review our experience with hepatic resection for colorectal cancer liver metastases. MATERIALS AND METHODS: From 1989 to 2006, we retrospectively analyzed the clinical experience of 31 patients who were underwent hepatic resection for 20 synchronous and 11 metachronous hepatic metastases from colorectal cancer. The survival rate was calculated using the Kaplan-Meier method and the log rank test. The mean follow up period was 26.7 months. RESULTS: The mean survival length of the patients was 65.08 5.00 months. Resection mortality was not observed. Age, sex, the preoperative CEA level, location, differentiation, and the surgical method for the primary tumor did not influence the survival (p>0.05). The number, largest size, sum of the largest size, and surgical method (wedge resection, segmental resection, lobectomy) for the hepatic metastasis did not influence the survival (p>0.05).Considering the time from diagnosis of the primary tumor to detection of the metastatic lesion, patients that had metachronous lesions survived longer than patients that had synchronous lesions (p=0.05). Patients that had a longer disease free interval after hepatic resection had a longer survival period (p=0.04). CONCLUSIONS: Our results suggest that hepatic resection for colorectal cancer liver metastasis is a safe procedure with a survival benefit for the patients. We especially believe that hepatic resection for metachronous hepatic metastasis of colorectal cancer may offer a chance of longer survival to these patients.