TY - JOUR
T1 - Resectability assessment of colorectal liver metastases by an expert panel
T2 - Potential impact on hospitals referring patients for local treatment
AU - Bond, Marinde J.G.
AU - Verhoef, Cornelis
AU - Kazemier, Geert
AU - Kok, Niels F.M.
AU - Gerhards, Michael F.
AU - Kuhlmann, Koert F.D.
AU - Leclercq, Wouter K.G.
AU - Rijken, Arjen M.
AU - Liem, Mike S.L.
AU - de Wilt, Johannes H.W.
AU - Klaase, Joost M.
AU - Chapelle, Thiery
AU - Grünhagen, Dirk J.
AU - Molenaar, I. Quintus
AU - van Dam, Ronald R.M.
AU - May, Anne M.
AU - Punt, Cornelis J.A.
AU - Swijnenburg, Rutger Jan
N1 - Publisher Copyright:
© 2025
PY - 2025/6
Y1 - 2025/6
N2 - 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.
AB - 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.
KW - Colorectal liver metastases
KW - Decision-making
KW - Expert panel
KW - Local treatment
KW - Resectability assessment
UR - http://www.scopus.com/inward/record.url?scp=85218905363&partnerID=8YFLogxK
U2 - 10.1016/j.ejso.2025.109681
DO - 10.1016/j.ejso.2025.109681
M3 - Article
AN - SCOPUS:85218905363
SN - 0748-7983
VL - 51
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 6
M1 - 109681
ER -