Resectability assessment of colorectal liver metastases by an expert panel: Potential impact on hospitals referring patients for local treatment

Marinde J.G. Bond, Cornelis Verhoef, Geert Kazemier, Niels F.M. Kok, Michael F. Gerhards, Koert F.D. Kuhlmann, Wouter K.G. Leclercq, Arjen M. Rijken, Mike S.L. Liem, Johannes H.W. de Wilt, Joost M. Klaase, Thiery Chapelle, Dirk J. Grünhagen, I. Quintus Molenaar, Ronald R.M. van Dam, Anne M. May, Cornelis J.A. Punt, Rutger Jan Swijnenburg*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Patients with colorectal liver-only metastases (CRLM) eligible for local treatment (resection/ablation) do not always receive this potentially curative treatment due to the lack of clear resectability criteria and expertise in centres not performing liver surgery. We evaluated the potential value of a liver expert panel in daily practice. Methods: All patients with CRLM starting with systemic treatment in centres not performing liver surgery between 2016 and 2020 were identified in the Netherlands Cancer Registry. A panel of liver surgeons retrospectively re-evaluated patients’ imaging for resectability before and two-monthly during systemic treatment. Results: Sixty-three patients were included from 24 hospitals requiring a total of 544 resectability assessments by individual panel surgeons. The panel considered 18 (29 %) patients to have resectable CRLM before starting systemic treatment, which increased to 43 (68 %) after up to three evaluations. Eighteen (29 %) patients considered resectable by the panel at any time received no local treatment of whom 9 (50 %) were not referred to a liver surgeon. Conclusion: In non-liver-surgery centres, over a quarter of patients technically eligible for local treatment of initially unresectable CRLM, sometimes mistakenly categorised as such, did not receive this. This stresses the need for liver expert panels in daily practice to increase local treatment rates.

Original languageEnglish
Article number109681
JournalEuropean Journal of Surgical Oncology
Volume51
Issue number6
DOIs
Publication statusPublished - Jun 2025

Keywords

  • Colorectal liver metastases
  • Decision-making
  • Expert panel
  • Local treatment
  • Resectability assessment

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