{Reference Type}: Journal Article
{Title}: Feasibility and Short-Term Outcomes in Liver-First Approach: A Spanish Snapshot Study (the RENACI Project).
{Author}: Serradilla-Martín M;Villodre C;Falgueras-Verdaguer L;Zambudio-Carroll N;Castell-Gómez JT;Blas-Laina JL;Borrego-Estella V;Domingo-Del-Pozo C;García-Plaza G;González-Rodríguez FJ;Montalvá-Orón EM;Moya-Herraiz Á;Paterna-López S;Suárez-Muñoz MA;Alkorta-Zuloaga M;Blanco-Fernández G;Dabán-Collado E;Gómez-Bravo MA;Miota-de-Llamas JI;Rotellar F;Sánchez-Pérez B;Sánchez-Cabús S;Pacheco-Sánchez D;Rodríguez-Sanjuan JC;Varona-Bosque MA;Carrión-Álvarez L;de la Serna-Esteban S;Dopazo C;Martín-Pérez E;Martínez-Cecilia D;Castro-Santiago MJ;Dorcaratto D;Gutiérrez-Díaz ML;Asencio-Pascual JM;Burdío-Pinilla F;Carracedo-Iglesias R;Escartín-Arias A;Ielpo B;Rodríguez-Laiz G;Valdivieso-López A;De-Vicente-López E;Alonso-Orduña V;Ramia JM;
{Journal}: Cancers (Basel)
{Volume}: 16
{Issue}: 9
{Year}: 2024 Apr 26
{Factor}: 6.575
{DOI}: 10.3390/cancers16091676
{Abstract}: (1) Background: The liver-first approach may be indicated for colorectal cancer patients with synchronous liver metastases to whom preoperative chemotherapy opens a potential window in which liver resection may be undertaken. This study aims to present the data of feasibility and short-term outcomes in the liver-first approach. (2) Methods: A prospective observational study was performed in Spanish hospitals that had a medium/high-volume of HPB surgeries from 1 June 2019 to 31 August 2020. (3) Results: In total, 40 hospitals participated, including a total of 2288 hepatectomies, 1350 for colorectal liver metastases, 150 of them (11.1%) using the liver-first approach, 63 (42.0%) in hospitals performing <50 hepatectomies/year. The proportion of patients as ASA III was significantly higher in centers performing ≥50 hepatectomies/year (difference: 18.9%; p = 0.0213). In 81.1% of the cases, the primary tumor was in the rectum or sigmoid colon. In total, 40% of the patients underwent major hepatectomies. The surgical approach was open surgery in 87 (58.0%) patients. Resection margins were R0 in 78.5% of the patients. In total, 40 (26.7%) patients had complications after the liver resection and 36 (27.3%) had complications after the primary resection. One-hundred and thirty-two (89.3%) patients completed the therapeutic regime. (4) Conclusions: There were no differences in the surgical outcomes between the centers performing <50 and ≥50 hepatectomies/year. Further analysis evaluating factors associated with clinical outcomes and determining the best candidates for this approach will be subsequently conducted.