EORTC 1409 GITCG/ESSO 01 - A prospective colorectal liver metastasis database for borderline or initially unresectable diseases (CLIMB): Lessons learnt from real life. From paradigm to unmet need

Maike Collienne, Anouk Neven, Carmela Caballero, Kozo Kataoka, Lucia Carrion-Alvarez, Henrik Nilsson, Grégoire Désolneux, Michel Rivoire, Theo Ruers, Thomas Gruenberger, Mladjan Protic, Roberto Ivan Troisi, Florian Primavesi, Stefan Staettner, Nuh Rahbari, Andreas Schnitzbauer, Hassan Malik, Rutger Jan Swijnenburg, Murielle Mauer, Michel DucreuxSerge Evrard

Résultats de recherche: Contribution à un journalArticleRevue par des pairs

3 Citations (Scopus)

Résumé

Aim: Multidisciplinary management of metastatic colorectal liver metastases (CRLM) is still challenging. To assess postoperative complications in initially unresectable or borderline resectable CRLM, the prospective EORTC-1409 ESSO 01-CLIMB trial capturing ‘real-life data’ of European centres specialized in liver surgery was initiated. Material and methods: A total of 219 patients were registered between May 2015 and January 2019 from 15 centres in nine countries. Eligible patients had borderline or initially unresectable CRLM assessed by pre-operative multidisciplinary team discussion (MDT). Primary endpoints were postoperative complications, 30-day and 90-days mortality post-surgery, and quality indicators. We report the final results of the 151 eligible patients that underwent at least one liver surgery. Results: Perioperative chemotherapy with or without targeted treatment were administered in 100 patients (69.4%). One stage resection (OSR) was performed in 119 patients (78.8%). Two stage resections (TSR, incl. Associating Liver Partition and Portal Vein Ligation for Staged hepatectomy (ALPPS)) were completed in 24 out of 32 patients (75%). Postoperative complications were reported in 55.5% (95% CI: 46.1–64.6%), 64.0% (95% CI: 42.5–82%), and 100% (95% CI: 59–100%) of the patients in OSR, TSR and ALPPS, respectively. Post-hepatectomy liver failure occurred in 6.7%, 20.0%, and 28.6% in OSR, TSR, and ALPPS, respectively. In total, four patients (2.6%) died after surgery. Conclusion: Across nine countries, OSR was more often performed than TSR and tended to result in less postoperative complications. Despite many efforts to register patients across Europe, it is still challenging to set up a prospective CRLM database.

langue originaleAnglais
Numéro d'article107081
journalEuropean Journal of Surgical Oncology
Volume49
Numéro de publication11
Les DOIs
étatPublié - 1 nov. 2023
Modification externeOui

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