Safety of Redo Hepatectomy for Colorectal Liver Metastases after Selective Interarterial Radiation Therapy: A Case Report

Surgical resection is the only potentially curative strategy in the treatment of patients with colorectal liver metastases (CLM). Unfortunately, only about 10%–15% of patients are candidates for resection. Preoperative chemotherapy aims to increase the number of patients that may be eligible for liver resection by downsizing liver metastases. For patients with unresectable, chemotherapy refractory CLM the available treatment options are limited. Selective interarterial radiation therapy (SIRT) is one of the most promising treatment options for this group of patients. Although only a small number of these patients have been reported as becoming candidates for potentially curative hepatic resection following sufficient reduction in the volume of liver metastases, the question arises regarding the safety of liver resection in these patients. We report a case of a patient who presented unresectable liver relapse of CLM after previous right hepatectomy. He underwent SIRT which resulted in downsizing of the liver metastases making the patient candidate for left lateral sectionectomy. He underwent the redo hepatectomy without any complications. To the best of our knowledge, this is the first reported case of redo hepatectomy after SIRT for CLM.

[1]  M. A. van den Bosch,et al.  Clinical and Laboratory Toxicity after Intra-Arterial Radioembolization with 90Y-Microspheres for Unresectable Liver Metastases , 2013, PloS one.

[2]  Ricky A. Sharma,et al.  Anatomical basis and histopathological changes resulting from selective internal radiotherapy for liver metastases , 2012, Journal of Clinical Pathology.

[3]  B. Kavanagh,et al.  Hepatic radiation toxicity: avoidance and amelioration. , 2011, Seminars in radiation oncology.

[4]  R. Praseedom,et al.  Selective internal radiation therapy with 90Y-SIR-Spheres microspheres for non-resectable colorectal metastases in the liver , 2011, BMJ Case Reports.

[5]  K. McMasters,et al.  Safety of hepatic resection in metastatic disease to the liver after yttrium-90 therapy. , 2011, The Journal of surgical research.

[6]  F. Izzo,et al.  Multi-centre phase II clinical trial of yttrium-90 resin microspheres alone in unresectable, chemotherapy refractory colorectal liver metastases , 2010, British Journal of Cancer.

[7]  D. Santini,et al.  Multimodal Sequential Approach in Colorectal Cancer Liver Metastases: Hepatic Resection after Yttrium-90 Selective Internal Radiation Therapy and Cetuximab Rescue Treatment , 2010, Tumori.

[8]  N. Nicolay,et al.  Liver metastases from colorectal cancer: radioembolization with systemic therapy , 2009, Nature Reviews Clinical Oncology.

[9]  M. A. Bosch,et al.  Yttrium-90 microsphere radioembolization for the treatment of liver malignancies: a structured meta-analysis , 2009, European Radiology.

[10]  M. Reiser,et al.  Hepatic yttrium-90 radioembolization of chemotherapy-refractory colorectal cancer liver metastases. , 2008, Journal of vascular and interventional radiology : JVIR.

[11]  B. Sangro,et al.  Liver disease induced by radioembolization of liver tumors , 2008, Cancer.

[12]  A. Carrato,et al.  Does chemotherapy prior to liver resection increase the potential for cure in patients with metastatic colorectal cancer? A report from the European Colorectal Metastases Treatment Group. , 2007, European journal of cancer.

[13]  C. McArdle,et al.  Epidemiology of colorectal liver metastases. , 2007, Surgical oncology.

[14]  P. Gibbs,et al.  Radioembolization of liver metastases from colorectal cancer using yttrium-90 microspheres with concomitant systemic oxaliplatin, fluorouracil, and leucovorin chemotherapy. , 2007, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[15]  C. Nutting,et al.  Resin 90Y-microsphere brachytherapy for unresectable colorectal liver metastases: modern USA experience. , 2006, International journal of radiation oncology, biology, physics.

[16]  L. Canedo,et al.  Strategies to treat primary unresectable colorectal liver metastases. , 2005, Seminars in oncology.

[17]  Ravi Murthy,et al.  Yttrium-90 microsphere therapy for hepatic malignancy: devices, indications, technical considerations, and potential complications. , 2005, Radiographics : a review publication of the Radiological Society of North America, Inc.

[18]  C. Nutting,et al.  Pathologic response and microdosimetry of (90)Y microspheres in man: review of four explanted whole livers. , 2004, International journal of radiation oncology, biology, physics.

[19]  G. van Hazel,et al.  Randomised phase 2 trial of SIR‐Spheres® plus fluorouracil/leucovorin chemotherapy versus fluorouracil/leucovorin chemotherapy alone in advanced colorectal cancer , 2004, Journal of surgical oncology.

[20]  L. Rubbia‐Brandt,et al.  Severe hepatic sinusoidal obstruction associated with oxaliplatin-based chemotherapy in patients with metastatic colorectal cancer. , 2004, Annals of oncology : official journal of the European Society for Medical Oncology.

[21]  R. Adam,et al.  Chemotherapy and surgery: new perspectives on the treatment of unresectable liver metastases. , 2003, Annals of oncology : official journal of the European Society for Medical Oncology.

[22]  A. Bouvier,et al.  Épidémiologie des métastases hépatiques des cancers colorectaux , 2003 .

[23]  Peter Boyle,et al.  Epidemiology of colorectal cancer. , 2002, British medical bulletin.

[24]  Michael A. Choti,et al.  Trends in Long-Term Survival Following Liver Resection for Hepatic Colorectal Metastases , 2002, Annals of surgery.

[25]  E. Schiff,et al.  Diagnostic laparoscopy in radiation-induced liver disease. , 2002, Gastrointestinal endoscopy.

[26]  V. Gebski,et al.  Randomised trial of SIR-Spheres plus chemotherapy vs. chemotherapy alone for treating patients with liver metastases from primary large bowel cancer. , 2001, Annals of oncology : official journal of the European Society for Medical Oncology.

[27]  J. Geoghegan,et al.  Treatment of colorectal liver metastases , 1999, The British journal of surgery.

[28]  M. Anscher,et al.  Hepatic toxicity resulting from cancer treatment. , 1995, International journal of radiation oncology, biology, physics.

[29]  A. Altendorf-Hofmann,et al.  Factors influencing the natural history of colorectal liver metastases , 1994, The Lancet.

[30]  H Berndt,et al.  [Epidemiology of colorectal cancer]. , 1991, Zeitschrift fur arztliche Fortbildung.

[31]  S. Tashiro,et al.  Studies on anticancer treatment with an oily anticancer drug injected into the ligated feeding hepatic artery for liver cancer , 1983, Cancer.

[32]  D. Doyon,et al.  [Hepatic, arterial embolization in patients with malignant liver tumours (author's transl)]. , 1974, Annales de radiologie.

[33]  A. Cox,et al.  The human liver after radiation injury. A form of veno-occlusive disease. , 1966, The American journal of pathology.

[34]  A. Poznanski,et al.  5-FLUOROURACIL TREATMENT OF LIVER METASTASES BY CONTINUOUS HEPATIC ARTERY INFUSION VIA COURNAND CATHETER: RESULTS AND SUITABILITY FOR INTENSIVE POSTSURGICAL ADJUVANT CHEMOTHERAPY. , 1963, Annals of surgery.

[35]  R. D. Wright The blood supply of newly developed epithelial tissue in the liver , 1937 .

[36]  P. Bossuyt,et al.  Evidence-base guideline on management of colorectal liver metastases in the Netherlands. , 2007, The Netherlands journal of medicine.

[37]  J. Mcloughlin,et al.  Resection of colorectal liver metastases: current perspectives. , 2006, Cancer control : journal of the Moffitt Cancer Center.

[38]  J. Fleshman,et al.  Liver resection for colorectal metastases. , 2004, Annals of the Royal College of Surgeons of England.

[39]  J. Faivre,et al.  [Epidemiology of colorectal cancer liver metastases]. , 2003, Bulletin de l'Academie nationale de medecine.