Feasibility and Short-Term Outcomes in Liver-First Approach: A Spanish Snapshot Study (the RENACI Project).

Fecha de publicación: 26/04/2024 Fecha Ahead of Print: 26/04/2024

Autores de IIS La Fe

Eva María Montalvá Orón

Autor

Participantes ajenos a IIS La Fe

Serradilla-Martín M
Villodre C
Falgueras-Verdaguer L
Zambudio-Carroll N
Castell-Gómez JT
Blas-Laina JL
Borrego-Estella V
Domingo-Del-Pozo C
García-Plaza G
González-Rodríguez FJ
Moya-Herraiz Á
Paterna-López S
Suárez-Muñoz MA
Alkorta-Zuloaga M
Blanco-Fernández G
Dabán-Collado E
Gómez-Bravo MA
Miota-de-Llamas JI
Rotellar F
Sánchez-Pérez B
Sánchez-Cabús S
Pacheco-Sánchez D
Rodríguez-Sanjuan JC
Varona-Bosque MA
Carrión-Álvarez L
de la Serna-Esteban S
Dopazo C
Martín-Pérez E
Martínez-Cecilia D
Castro-Santiago MJ
Dorcaratto D
Gutiérrez-Díaz ML
Asencio-Pascual JM
Burdío-Pinilla F
Carracedo-Iglesias R
Escartín-Arias A
Ielpo B
Rodríguez-Laiz G
Valdivieso-López A
De-Vicente-López E
Alonso-Orduña V
Ramia JM

Grupos

Hepatología, Cirugia Hepatobiliopancreática y Trasplantes

Leader

Marina Berenguer Haym

Abstract

(1) Background: The liver-first approach may be indicated for colorectal cancer patients with synchronous liver metastases to whom preoperative chemotherapy opens a potential window in which liver resection may be undertaken. This study aims to present the data of feasibility and short-term outcomes in the liver-first approach. (2) Methods: A prospective observational study was performed in Spanish hospitals that had a medium/high-volume of HPB surgeries from 1 June 2019 to 31 August 2020. (3) Results: In total, 40 hospitals participated, including a total of 2288 hepatectomies, 1350 for colorectal liver metastases, 150 of them (11.1%) using the liver-first approach, 63 (42.0%) in hospitals performing <50 hepatectomies/year. The proportion of patients as ASA III was significantly higher in centers performing =50 hepatectomies/year (difference: 18.9%; p = 0.0213). In 81.1% of the cases, the primary tumor was in the rectum or sigmoid colon. In total, 40% of the patients underwent major hepatectomies. The surgical approach was open surgery in 87 (58.0%) patients. Resection margins were R0 in 78.5% of the patients. In total, 40 (26.7%) patients had complications after the liver resection and 36 (27.3%) had complications after the primary resection. One-hundred and thirty-two (89.3%) patients completed the therapeutic regime. (4) Conclusions: There were no differences in the surgical outcomes between the centers performing <50 and =50 hepatectomies/year. Further analysis evaluating factors associated with clinical outcomes and determining the best candidates for this approach will be subsequently conducted.

Datos de la publicación

ISSN/ISSNe:: 2072-6694, 2072-6694
Tipo:: Article
Páginas:: -
DOI:: 10.3390/cancers16091676
Factor de Impacto:: 1,349 SCImago ℠
Cuartil:: Q1 SCImago ℠

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Filiaciones

Serradilla-Martín M:: Department of Surgery, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain

Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain

Department of Surgery, School of Medicine, University of Granada, 18016 Granada, Spain
Villodre C:: Department of Surgery, Hospital General Universitario Dr. Balmis, 03010 Alicante, Spain

ISABIAL, Instituto de Investigación Sanitaria y Biomédica de Alicante, 03010 Alicante, Spain

Department of Surgery, Universidad Miguel Hernández, 03202 Alicante, Spain
Falgueras-Verdaguer L:: Department of Surgery, Hospital Universitario Dr. Josep Trueta, 17007 Girona, Spain
Zambudio-Carroll N:: Department of Surgery, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
Castell-Gómez JT:: Department of Surgery, Hospital Universitario La Paz, 28046 Madrid, Spain
Blas-Laina JL:: Department of Surgery, Hospital Royo Villanova, 50015 Zaragoza, Spain
Borrego-Estella V:: Department of Surgery, Hospital Universitario Lozano Blesa, 50009 Zaragoza, Spain
Domingo-Del-Pozo C:: Department of Surgery, Hospital Universitario Dr. Peset, 46017 Valencia, Spain
García-Plaza G:: Department of Surgery, Hospital Universitario Insular, 35016 Las Palmas de Gran Canaria, Spain
González-Rodríguez FJ:: Department of Surgery, Hospital Clínico Universitario de Santiago, 15706 Santiago de Compostela, Spain
Montalvá-Orón EM:: Instituto de Investigación. Department of Surgery, Hospital Universitario y Politécnico La Fe, IIS La Fe, Ciberehd ISCIII, 46026 Valencia, Spain
Moya-Herraiz Á:: Department of Surgery, Hospital Universitario de Castellón, 12004 Castelló de la Plana, Spain
Paterna-López S:: Department of Surgery, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain
Suárez-Muñoz MA:: Department of Surgery, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain
Alkorta-Zuloaga M:: Department of Surgery, Hospital Universitario Donostia, 20014 San Sebastián, Spain
Blanco-Fernández G:: Department of Surgery, Hospital Universitario de Badajoz, 06006 Badajoz, Spain
Dabán-Collado E:: Department of Surgery, Hospital Universitario San Cecilio, 18016 Granada, Spain
Gómez-Bravo MA:: Department of Surgery, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain
Miota-de-Llamas JI:: Department of Surgery, Hospital Universitario de Albacete, 02006 Albacete, Spain
Rotellar F:: Department of Surgery, Clínica Universidad de Navarra, 31008 Pamplona, Spain
Sánchez-Pérez B:: Department of Surgery, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
Sánchez-Cabús S:: Department of Surgery, Hospital Universitario de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
Pacheco-Sánchez D:: Department of Surgery, Hospital Universitario Río Hortega, 47012 Valladolid, Spain
Rodríguez-Sanjuan JC:: Department of Surgery, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain
Varona-Bosque MA:: Department of Surgery, Hospital Universitario Nuestra Señora de la Candelaria, 38010 Santa Cruz de Tenerife, Spain
Carrión-Álvarez L:: Department of Surgery, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
de la Serna-Esteban S:: Department of Surgery, Hospital Clínico Universitario, 28040 Madrid, Spain
Dopazo C:: Department of Surgery, Hospital Universitario Vall d'Hebron, 08035 Barcelona, Spain
Martín-Pérez E:: Department of Surgery, Hospital Universitario La Princesa, 28006 Madrid, Spain
Martínez-Cecilia D:: Department of Surgery, Hospital Universitario La Princesa, 28006 Madrid, Spain

Department of Surgery, Hospital Universitario Virgen de la Salud, 45004 Toledo, Spain
Castro-Santiago MJ:: Department of Surgery, Hospital Universitario Puerta del Mar, 11009 Cádiz, Spain
Dorcaratto D:: Department of Surgery, Hospital Clínico Universitario, 46010 Valencia, Spain
Gutiérrez-Díaz ML:: Department of Surgery, Hospital Quirón, 50006 Zaragoza, Spain
Asencio-Pascual JM:: Department of Surgery, Hospital Universitario Gregorio Marañón, 28007 Madrid, Spain
Burdío-Pinilla F:: Department of Surgery, Hospital Universitario del Mar, 08003 Barcelona, Spain
Carracedo-Iglesias R:: Department of Surgery, Hospital Universitario Álvaro Cunqueiro, 36312 Vigo, Spain
Escartín-Arias A:: Department of Surgery, Hospital Universitario Arnau de Vilanova, 25198 Lleida, Spain
Ielpo B:: Department of Surgery, Hospital Universitario del Mar, 08003 Barcelona, Spain

Department of Surgery, Hospital Universitario de León, 24008 León, Spain
Rodríguez-Laiz G:: Department of Surgery, Hospital General Universitario Dr. Balmis, 03010 Alicante, Spain
Valdivieso-López A:: Department of Surgery, Hospital Universitario de Cruces, 48903 Barakaldo, Spain
De-Vicente-López E:: Department of Surgery, Hospital Universitario HM Sanchinarro, 28050 Madrid, Spain
Alonso-Orduña V:: Department of Medical Oncology, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain
Ramia JM:: Department of Surgery, Hospital General Universitario Dr. Balmis, 03010 Alicante, Spain

ISABIAL, Instituto de Investigación Sanitaria y Biomédica de Alicante, 03010 Alicante, Spain

Department of Surgery, Universidad Miguel Hernández, 03202 Alicante, Spain