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Disappearing liver metastases: A systematic review of the current evidence.

Publication ,  Journal Article
Tsilimigras, DI; Ntanasis-Stathopoulos, I; Paredes, AZ; Moris, D; Gavriatopoulou, M; Cloyd, JM; Pawlik, TM
Published in: Surgical oncology
June 2019

Advances in systemic chemotherapy have resulted in a significant increase in the reported response rates of colorectal liver metastases (CRLM) over time. Although radiologic response is usually prognostic of favorable outcomes, complete shrinkage of CRLM after chemotherapy, namely "disappearing liver metastases" (DLMs) poses significant therapeutic dilemmas. A systematic review of the literature was conducted to evaluate the existing evidence on the imaging and management of patients with DLMs using the PubMed (Medline), Embase and Cochrane library through December 21st, 2018. The following algorithm was used: "(disappearing OR vanishing OR missing OR (residual tiny)) AND ((liver OR hepatic) AND (metastasis OR metastases OR metastatic OR secondary))." From the 225 records retrieved, 15 studies were finally deemed eligible. A total of 479 patients with DLMs with a median age of 59.5 years (range, 30-83) were identified. Median number of DLM per patient ranged from 1 to 8.8. Median size of LMs prior to chemotherapy was 1.07 cm (range 0.3-3.5). The systemic treatment used to achieve DLMs included systemic chemotherapy alone (only 2 studies) or in combination with targeted agents (11 studies). The median number of chemotherapy cycles in the included studies was 7.8 (range 6-12). Identified factors predisposing to the development of DLM were small size (<2 cm), increased number of treatment cycles, oxaliplatin-based therapy, increased number of CRLM (≥3) and synchronous CRLM. Baseline and preoperative MRI with iv contrast showed the highest sensitivity for DLM detection. Fiducial placement facilitated pre- and intra-operative identification of DLM. Although resection of DLM decreased the local recurrence risk, there was no clearly demonstrated survival benefit after resecting all sites of disappearing lesions. Future randomized clinical trials are highly encouraged to provide strict, evidence-based recommendations for the treatment of patients with DLM.

Duke Scholars

Published In

Surgical oncology

DOI

EISSN

1879-3320

ISSN

0960-7404

Publication Date

June 2019

Volume

29

Start / End Page

7 / 13

Related Subject Headings

  • Survival Rate
  • Prognosis
  • Oncology & Carcinogenesis
  • Liver Neoplasms
  • Humans
  • Colorectal Neoplasms
  • 3211 Oncology and carcinogenesis
  • 3203 Dentistry
  • 3202 Clinical sciences
  • 1112 Oncology and Carcinogenesis
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Tsilimigras, D. I., Ntanasis-Stathopoulos, I., Paredes, A. Z., Moris, D., Gavriatopoulou, M., Cloyd, J. M., & Pawlik, T. M. (2019). Disappearing liver metastases: A systematic review of the current evidence. Surgical Oncology, 29, 7–13. https://doi.org/10.1016/j.suronc.2019.02.005
Tsilimigras, Diamantis I., Ioannis Ntanasis-Stathopoulos, Anghela Z. Paredes, Dimitrios Moris, Maria Gavriatopoulou, Jordan M. Cloyd, and Timothy M. Pawlik. “Disappearing liver metastases: A systematic review of the current evidence.Surgical Oncology 29 (June 2019): 7–13. https://doi.org/10.1016/j.suronc.2019.02.005.
Tsilimigras DI, Ntanasis-Stathopoulos I, Paredes AZ, Moris D, Gavriatopoulou M, Cloyd JM, et al. Disappearing liver metastases: A systematic review of the current evidence. Surgical oncology. 2019 Jun;29:7–13.
Tsilimigras, Diamantis I., et al. “Disappearing liver metastases: A systematic review of the current evidence.Surgical Oncology, vol. 29, June 2019, pp. 7–13. Epmc, doi:10.1016/j.suronc.2019.02.005.
Tsilimigras DI, Ntanasis-Stathopoulos I, Paredes AZ, Moris D, Gavriatopoulou M, Cloyd JM, Pawlik TM. Disappearing liver metastases: A systematic review of the current evidence. Surgical oncology. 2019 Jun;29:7–13.
Journal cover image

Published In

Surgical oncology

DOI

EISSN

1879-3320

ISSN

0960-7404

Publication Date

June 2019

Volume

29

Start / End Page

7 / 13

Related Subject Headings

  • Survival Rate
  • Prognosis
  • Oncology & Carcinogenesis
  • Liver Neoplasms
  • Humans
  • Colorectal Neoplasms
  • 3211 Oncology and carcinogenesis
  • 3203 Dentistry
  • 3202 Clinical sciences
  • 1112 Oncology and Carcinogenesis