Introduction Almost 25% of colorectal cancer (CRC) patients have synchronous
colorectal liver metastasis (SCLM) coinciding with the disease diagnosis. Liver-first
approach for the treatment of SCLM involves neoadjuvant chemotherapy, subsequent
liver resection, and then primary tumor resection. This strategy is adopted as the
prognosis of the disease depends mainly on the metastases, not the primary tumor.
This study aims to evaluate the feasibility of the liver-first approach and clinical
prognosis in managing SCLM.
Materials and Methods This retrospective study included 25 patientswith SCLM from
July 2015 to July 2020. All patients were subjected to a liver-first approach with an
“intention-to-treat” approach. Follow-up was planned for at least 3 years. Data were
collected from the hospital records and included survival rates and univariate analyses
of the prognostic factors, such as gender, age, and number of chemotherapy cycles to
evaluate their effect on the survival probability.
Results Nineteen patients completed the treatment paradigm. Long-term outcomes
reported a median overall survival (OS) of 32 months. One-year and 3-year survival
probabilities were 89.5% and 42.1%, respectively. Themedian disease-free survival was
13 months. The number of metastatic lesions, unilobar versus bilobar disease, and the
frequency of administered chemotherapy cycles significantly affected survival
(p |
