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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, Montalvá-Orón EM, 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. Feasibility and Short-Term Outcomes in Liver-First Approach: A Spanish Snapshot Study (the RENACI Project). Cancers (Basel) 2024; 16:1676. [PMID: 38730631 PMCID: PMC11082946 DOI: 10.3390/cancers16091676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 04/21/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024] Open
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.
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Affiliation(s)
- Mario Serradilla-Martín
- 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
| | - Celia Villodre
- Department of Surgery, Hospital General Universitario Dr. Balmis, 03010 Alicante, Spain; (C.V.); (J.M.R.)
- ISABIAL, Instituto de Investigación Sanitaria y Biomédica de Alicante, 03010 Alicante, Spain
- Department of Surgery, Universidad Miguel Hernández, 03202 Alicante, Spain
| | | | | | | | | | | | | | - Gabriel García-Plaza
- Department of Surgery, Hospital Universitario Insular, 35016 Las Palmas de Gran Canaria, Spain;
| | | | - Eva M. Montalvá-Orón
- Department of Surgery, Hospital Universitario y Politécnico La Fe, IIS La Fe, Ciberehd ISCIII, 46026 Valencia, Spain;
| | - Ángel Moya-Herraiz
- Department of Surgery, Hospital Universitario de Castellón, 12004 Castelló de la Plana, Spain;
| | - Sandra Paterna-López
- Department of Surgery, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain;
| | - Miguel A. Suárez-Muñoz
- Department of Surgery, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain;
| | | | | | | | - Miguel A. Gómez-Bravo
- Department of Surgery, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain;
| | | | - Fernando Rotellar
- Department of Surgery, Clínica Universidad de Navarra, 31008 Pamplona, Spain;
| | - Belinda Sánchez-Pérez
- Department of Surgery, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain;
| | - Santiago Sánchez-Cabús
- Department of Surgery, Hospital Universitario de la Santa Creu i Sant Pau, 08041 Barcelona, Spain;
| | | | | | - María A. Varona-Bosque
- Department of Surgery, Hospital Universitario Nuestra Señora de la Candelaria, 38010 Santa Cruz de Tenerife, Spain;
| | | | | | - Cristina Dopazo
- Department of Surgery, Hospital Universitario Vall d’Hebron, 08035 Barcelona, Spain;
| | - Elena Martín-Pérez
- Department of Surgery, Hospital Universitario La Princesa, 28006 Madrid, Spain; (E.M.-P.); (D.M.-C.)
| | - David Martínez-Cecilia
- Department of Surgery, Hospital Universitario La Princesa, 28006 Madrid, Spain; (E.M.-P.); (D.M.-C.)
- Department of Surgery, Hospital Universitario Virgen de la Salud, 45004 Toledo, Spain
| | | | - Dimitri Dorcaratto
- Department of Surgery, Hospital Clínico Universitario, 46010 Valencia, Spain;
| | | | | | - Fernando Burdío-Pinilla
- Department of Surgery, Hospital Universitario del Mar, 08003 Barcelona, Spain; (F.B.-P.); (B.I.)
| | | | | | - Benedetto Ielpo
- Department of Surgery, Hospital Universitario del Mar, 08003 Barcelona, Spain; (F.B.-P.); (B.I.)
- Department of Surgery, Hospital Universitario de León, 24008 León, Spain
| | - Gonzalo Rodríguez-Laiz
- Department of Surgery, Hospital General Universitario Dr. Balmis, 03010 Alicante, Spain; (C.V.); (J.M.R.)
| | | | | | - Vicente Alonso-Orduña
- Department of Medical Oncology, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain;
| | - José M. Ramia
- Department of Surgery, Hospital General Universitario Dr. Balmis, 03010 Alicante, Spain; (C.V.); (J.M.R.)
- ISABIAL, Instituto de Investigación Sanitaria y Biomédica de Alicante, 03010 Alicante, Spain
- Department of Surgery, Universidad Miguel Hernández, 03202 Alicante, Spain
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