TY - JOUR
T1 - EORTC 1409 GITCG/ESSO 01 - A prospective colorectal liver metastasis database for borderline or initially unresectable diseases (CLIMB)
T2 - Lessons learnt from real life. From paradigm to unmet need
AU - Collienne, Maike
AU - Neven, Anouk
AU - Caballero, Carmela
AU - Kataoka, Kozo
AU - Carrion-Alvarez, Lucia
AU - Nilsson, Henrik
AU - Désolneux, Grégoire
AU - Rivoire, Michel
AU - Ruers, Theo
AU - Gruenberger, Thomas
AU - Protic, Mladjan
AU - Troisi, Roberto Ivan
AU - Primavesi, Florian
AU - Staettner, Stefan
AU - Rahbari, Nuh
AU - Schnitzbauer, Andreas
AU - Malik, Hassan
AU - Swijnenburg, Rutger Jan
AU - Mauer, Murielle
AU - Ducreux, Michel
AU - Evrard, Serge
N1 - Publisher Copyright:
© 2023
PY - 2023/11/1
Y1 - 2023/11/1
N2 - 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.
AB - 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.
KW - 2-Stage hepatectomies
KW - ALPPS
KW - Colorectal cancer
KW - Colorectal liver metastasis
KW - Major hepatectomy
KW - Parenchyma sparing surgery
KW - Postoperative complications
KW - Prospective non-randomized study
KW - Quality control
UR - http://www.scopus.com/inward/record.url?scp=85173182949&partnerID=8YFLogxK
U2 - 10.1016/j.ejso.2023.107081
DO - 10.1016/j.ejso.2023.107081
M3 - Article
C2 - 37793303
AN - SCOPUS:85173182949
SN - 0748-7983
VL - 49
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 11
M1 - 107081
ER -