Single center experience – end results of surgical treatment of 200 patients with colorectal liver metastases

Electronic Poster Abstracts Introduction: For the patients receiving preoperative modern chemotherapy, the clinical indicator derived from clinicopathologic data of chemotherapy-naive patients with colorectal liver metastases might not work well. To clarify whether treatment-induced changes, determined by preoperatively measured variables, can predict outcome after resection of colorectal liver metastases. Methods: Medical records of 54 consecutive patients undergoing resection of colorectal metastases to the liver during 2008 to 2013 were reviewed. Fourteen demographic and clinicopathologic factors, including chemotherapyaffected variables (number, size and volume of tumors and CEA level) were analyzed for overall (OS) and recurrencefree survival (RFS). Results: The 1-, 3-, and 5-year OS rates were 83.1%, 52.2%, and 35.0%, respectively. When tumor volume was reduced by more than 90% from initial estimation, none of the patients died during the observation period. Forty-two of 48 (88%) patients without gross residual tumors had disease recurrence with 1-, 3-, and 5-year RFS rates of 27.1%, 12.5% and 12.5%, respectively. On multivariate analysis, complete resection and tumor volume reduction to less than 30% were independent predictors of favorable OS after hepatectomy. Tumor volume reduction was an independent indicators of recurrence together with other five factors. Conclusion: Estimation of tumor volume reduction by preoperative chemotherapy, which can be determined preoperatively, could serve as a potent surrogate to predict post-resection outcome.

EP01A-032 SINGLE CENTER EXPERIENCE e END RESULTS OF SURGICAL TREATMENT OF 200 PATIENTS WITH COLORECTAL LIVER METASTASES M. Correia1,2, C. E. Rodrigues Santos3, R. Albagli3, L. Castro3, R. Goncalves3, M. Lannes1, J. H. Luz1 and H. Salas3 1 Liver Group, Instituto Nacional de Câncer e Brazil, 2 Cirurgia Geral, UNIGRANRIO, and 3Liver Group, Instituto Nacional do Câncer e Inca, Brazil Tthis work describes the results of surgical treatment of 200 patients with colorectal liver metastases (CRLM) from a single center e The National Cancer Institute of Brazil. The study has been aproved by the ethics commitee of the institution under the authorization number 030/06. Two hundred patients submited to liver resection for CRLM between 1996 and 2011 have been followed. There were 91 men (60,7%) and 59 women (39,3%). the age range was from 25 to 91. The median age was 62. The main site of the primary tumor was the left colon and rectum (70%). The most common surgery was segmentectomy (31%) followed by nodulectomy (26,5%). The morbidity rate was 30% and mortality 6%. Both have been related with major resections, including one ex situ ex vivo. The 5 year survival rate was 33% and the 10 year survival rate was 15%. The paper describes the role of prognostic factors for mortality and survival including neoadjuvant chemotherapy.

HPB 2016, 18 (S1), e1ee384

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EP01A-034 THE IMPACT OF ADVANCING AGE AND ADJUVANT CHEMOTHERAPY ON RECURRENCE AND SURVIVAL FOLLOWING MAJOR HEPATECTOMY FOR COLORECTAL LIVER METASTASES R. Bell1, S. Pandanaboyana2, S. Nisar1, P. Lodge1 and R. Prasad1 1 Department of Hepatobiliary and Transplant Surgery, St James’ University Hospital, United Kingdom, and 2 Department of Hepatobiliary and Transplant Surgery, Auckland City Hospital, New Zealand Introduction: This study analyzed the effect of increasing age on survival in patients undergoing major hepatectomy for colorectal liver metastases (CRLM). The effect of adjuvant chemotherapy (AC) with age was also assessed. Method: Patients undergoing major hepatectomy for CRLM between 1994 and 2011 were examined. Patients were grouped according to age < 75 or 75. Disease free (DFS) and overall survival (OS) was compared. Impact of AC on survival in the 75 group was also assessed. Results: 727 patients underwent major resection. 105 (14%) were aged 75 and 622 (86%) were < 75. Morbidity was greater in the 75 group (25% versus 34%, p = 0.048). No difference was noted in 90-day mortality. There was no difference in DFS between the 2 groups (p = 0.570), OS was longer in the < 75 group (p = 0.001). DFS was better in both groups that received AC than those that did not (p <  0.001 and 0.007). OS in the 75 group was improved in the group receiving AC compared to the 75 group not receiving AC (p = 0.005). Age 75 was not an independent risk factor for reduced DFS. Conclusion: Acceptable results can be achieved in patients aged 75 undergoing major hepatectomy followed by AC.

EP01A-035 ASSESSMENT OF THE VALUE OF POSITRON EMISSION TOMOGRAPHY IN THE PRE-OPERATIVE STAGING OF COLORECTAL LIVER METASTASES S. Ulyett South-West Liver Unit, Derriford Hospital, United Kingdom Introduction: Pre-operative assessment of colorectal liver metastases (CRM) and selection of suitable patients is demanding. Multi-modal imaging uses various techniques, including positron emission tomography (PET). PET is predominantly used for detecting extra-hepatic disease and has improved sensitivity compared to CT. However, it is unclear if PET actually improves outcomes. The aim was to determine if pre-operative PET improves survival and recurrence. Method: Prospectively collected data were extracted from the HPB unit database. All liver resections, performed with curative intent, for CRM from July 2005 until February 2015 were included. Follow-up was completed in June 2015. Patients were excluded from recurrence analysis if