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Master Thesis

Intérêt d’une chirurgie hépatique non conventionnelle à visée de réduction tumorale dans les cancers colorectaux métastatiques hépatiques : une étude rétrospective

Abstract : Objectives: more than 80% of colorectal cancer liver metastasis (CRCLM) are considered to be initially unresecable according to the resecability criteria established by the French National Thesaurus for Gastro-Intestinal Oncology (TNCD). Our objective was to determine the results of an unconventional surgery of CRCLM and assess the pre-operative predictive factors in order to select patients who are likely to benefit from it.
Methods: between 1998 and 2018 at the Institut Mutualiste Montsouris, 140 patients undergoing a questionable CRCLM surgery, in the light of the TNCD recommendations, were retrospectively included, of which 79 treated by expertly performed procedures (group 1) and 61 treated in a cytoreductive strategy (group 2). Univariate and multivariate logistic regression analyses were performed to evaluate and compare predictive factors of disease-free survival (DFS) in each group, using Chi-square, Kaplan-Meier and Cox model.
Results: group 2 median DFS was 5.5 months. The multivariate analysis of this group revealed that bilobar metastasis before the last surgical procedure (p = 0,016), extra-hepatic sites (p = 0,028), 10 or more LM (p = 0,038) and less than 3 surgical procedure (p = 0,041) were significantly associated with the risk of disease progression.
Conclusion: an aggressive palliative surgical cytoreductive approach offers an appreciable DFS and tumoral control, particularly after 3 procedures, except in the case of more than 9 LM, bilobar or extra-hepatic sites.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03481176
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Submitted on : Wednesday, December 15, 2021 - 10:51:00 AM
Last modification on : Thursday, April 7, 2022 - 2:28:02 PM
Long-term archiving on: : Wednesday, March 16, 2022 - 6:27:26 PM

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Nita Usdin. Intérêt d’une chirurgie hépatique non conventionnelle à visée de réduction tumorale dans les cancers colorectaux métastatiques hépatiques : une étude rétrospective. Médecine humaine et pathologie. 2020. ⟨dumas-03481176⟩

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