Current Situation Regarding Management of Colorectal Carcinomas in the Region of Hradec Kralove (East Bohemia)

Česká verzia

Authors: Z. Šubrt ^1,2; B. Jon ¹; Č. Neoral ³; A. Ferko ^1,2; F. Čečka ¹; T. Dušek ^1,2; B. Melichar ⁴
Authors place of work: Chirurgická klinika Fakultní nemocnice Hradec Králové a Lékařské fakulty UK v Hradci Králové přednosta kliniky: doc. MUDr. A. Ferko, CSc. ¹; Katedra válečné chirurgie, Fakulta vojenského zdravotnictví, Univerzita Obrany Brno vedoucí katedry: doc. MUDr. L. Klein, CSc. ²; I. chirurgická klinika Fakultní nemocnice Olomouc a Lékařské fakulty Univerzity Palackého Olomouc přednosta kliniky: doc. MUDr. Č. Neoral, CSc. ³; Onkologická klinika Fakultní nemocnice Olomouc a Lékařské fakulty Univerzity Palackého Olomouc přednosta kliniky: prof. MUDr. B. Melichar, Ph. D. ⁴
Published in the journal: Rozhl. Chir., 2008, roč. 87, č. 12, s. 654-658.
Category: Monothematic special - Original

Summary

Introduction:
The aim of this clinical study was to evaluate the current state of treatment of liver metastases from colorectal cancer (CRC) in the Hradec Králové region.

Methods:
All patients undergoing large bowel resection for CRC in all nine surgical departments in the Hradec Králové region between January 2002 and December 2003 were retrospectively analyzed. The course of the disease and further treatment with reference to isolated liver metastases were evaluated.

Results:
In 663 patients operated on for CRC, synchronous hepatic metastases were diagnosed in 137 (21%) and metachronous liver metastases were diagnosed in 111 (28%) patients. The isolated liver metastases were found in 132 of 663 (20%) patients. Only 14 of 132 (11%) patients underwent liver resection. Ablation therapy was used in four (3%) patients. Loco-regional chemotherapy was applied in 22 (17%) patients and systemic chemotherapy was administered to 94 (72%). Thirty-one (24%) patients were not actively treated at all.

Conclusion:
The results of our study suggest that only a small group of patients with isolated liver metastases is referred for resection, especially in a specialized centre.

Key words:
colorectal cancer – liver metastases – liver resection – population based study – survival

Zdroje

1. Alley, P. G., McNee, R. K. Colorectal cancer in Auckland 1981–1982: patients with liver metastases. N. Z. Med. J., 1985; 98: 697–699.

2. Bengtsson, G., Carlsson, G., Hafstrom, L., Jonsson, P. E. Natural history of patients with untreated liver metastases from colorectal cancer. Am. J. Surg., 1981; 141: 586–589.

3. Birth, M., Hildebrand, P., Dahmen, G., et al. Present state of radio frequency ablation of liver tumors in Germany. Chirurg, 2004; 75: 417–423.

4. Cummings, L. C., Payes, J. D., Cooper, G. S. Survival after hepatic resection in metastatic colorectal cancer: a population-based study. Cancer, 2007; 109: 718–726.

5. Fong, Y. A promising technique for liver cancer? Cancer J. Sci. Am., 1999; 5: 339–340.

6. Gatta, G., Capocaccia, R., Sant, M., et al. Understanding variations in survival for colorectal cancer in Europe: a EUROCARE high resolution study. Gut, 2000; 47: 533–538.

7. Karanjia, N. D., Rees, M., Schache, D., Heald, R. J. Hepatic resection for colorectal secondaries. Br. J. Surg., 1990; 77: 27–29.

8. Kune, G. A., Kune, S., Field, B., et al. Survival in patients with large-bowel cancer. A population-based investigation from the Melbourne Colorectal Cancer Study. Dis. Colon Rectum, 1990; 33: 938–946.

9. Leporrier, J., Maurel, J., Chiche, L., Bara, S., Segol, P., Launoy, G. A population-based study of the incidence, management and prognosis of hepatic metastases from colorectal cancer. Br. J. Surg., 2006; 93: 465–474.

10. Manfredi, S., Lepage, C., Hatem, C., Coatmeur, O., Faivre, J., Bouvier, A. M. Epidemiology and management of liver metastases from colorectal cancer. Ann. Surg., 2006; 244: 254–259.

11. Pantoflíček, J., Ryska, M., Bělina, F. Léčba jaterních metastáz kolorektálního původu v České republice – Výsledky celostátní dotazníkové akce. Bulletin HPB., 2002; 10: 105–109.

12. Sjovall, A., Jarv, V., Blomqvist, L., et al. The potential for improved outcome in patients with hepatic metastases from colon cancer: a population-based study. Eur. J. Surg. Oncol., 2004; 30: 834–841.

13. Válek, V., Kala, Z., Kiss, I. Maligní ložiskové procesy jater. Diagnostika a léčba včetně minimálně invazivních metod. Praha, Grada Publishing, 2006.