48331ed18811a5408d9b8ac9ab264827 313093.pdf f993cc262cc0091b480979201913e993cbdbcfb2 313093.pdf c1337b8a3916295dca7f8a08552e236ba4afe52a2d74247cecb0cda546aed1b4 313093.pdf Title: Feasibility and Short-Term Outcomes in Liver-First Approach: A Spanish Snapshot Study (the RENACI Project) Subject: (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. Keywords: colorectal cancer; liver metastases; liver-first approach; disease-free survival Author: Mario Serradilla-Martín, Celia Villodre, Laia Falgueras-Verdaguer, Natalia Zambudio-Carroll, José T. Castell-Gómez, Juan L. Blas-Laina, Vicente Borrego-Estella, Carlos Domingo-del-Pozo, Gabriel García-Plaza, Francisco J. González-Rodríguez, Eva M. Montalvá-Orón, Ángel Moya-Herraiz, Sandra Paterna-López, Miguel A. Suárez-Muñoz, Maialen Alkorta-Zuloaga, Gerardo Blanco-Fernández, Enrique Dabán-Collado, Miguel A. Gómez-Bravo, José I. Miota-de-Llamas, Fernando Rotellar, Belinda Sánchez-Pérez, Santiago Sánchez-Cabús, David Pacheco-Sánchez, Juan C. Rodríguez-Sanjuan, María A. Varona-Bosque, Lucía Carrión-Álvarez, Sofía de la Serna-Esteban, Cristina Dopazo, Elena Martín-Pérez, David Martínez-Cecilia, María J. Castro-Santiago, Dimitri Dorcaratto, Marta L. Gutiérrez-Díaz, José M. Asencio-Pascual, Fernando Burdío-Pinilla, Roberto Carracedo-Iglesias, Alfredo Escartín-Arias, Benedetto Ielpo, Gonzalo Rodríguez-Laiz, Andrés Valdivieso-López, Emilio De-Vicente-López, Vicente Alonso-Orduña and José M. Ramia Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Fri Apr 26 11:41:14 2024 CEST ModDate: Fri Apr 26 11:43:27 2024 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 16 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 304000 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- WIRPUU+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 TKGELB+URWPalladioL-Bold Type 1 Custom yes yes yes 16 0 NNKMGC+URWPalladioL-Roma Type 1 Custom yes yes yes 22 0 HHPOEW+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 HCRKXL+VnURWPalladioL Type 1 Custom yes yes yes 32 0 LCJEVJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 49 0 GQWIGS+CMSY10 Type 1 Builtin yes yes yes 66 0 FAECIJ+URWPalladioL-BoldItal Type 1 Custom yes yes yes 83 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-07-01 02:42:38 CEST RepresentationInformation: 313093.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-06-30 14:10:25 CEST Size: 304000 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 324 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Design Destination: subsection.2.1 Item: Title: The RENACI Project Destination: subsection.2.2 Item: Title: Patients Destination: subsection.2.3 Item: Title: Inclusion/Exclusion Criteria Destination: subsection.2.4 Item: Title: Treatment Strategy Destination: subsection.2.5 Item: Title: Outcomes Destination: subsection.2.6 Item: Title: Study Variables Destination: subsection.2.7 Item: Title: Statistical Analysis Destination: subsection.2.8 Item: Title: Results Destination: section.3 Children: Item: Title: General Information Destination: subsection.3.1 Item: Title: Preoperative Clinical and Demographic Characteristics Destination: subsection.3.2 Item: Title: Liver Resection Procedure Destination: subsection.3.3 Item: Title: Characteristics of the Primary Tumour Surgical Procedure Destination: subsection.3.4 Item: Title: Safety Destination: subsection.3.5 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.6 Info: Title: Feasibility and Short-Term Outcomes in Liver-First Approach: A Spanish Snapshot Study (the RENACI Project) Author: Mario Serradilla-Martín, Celia Villodre, Laia Falgueras-Verdaguer, Natalia Zambudio-Carroll, José T. Castell-Gómez, Juan L. Blas-Laina, Vicente Borrego-Estella, Carlos Domingo-del-Pozo, Gabriel García-Plaza, Francisco J. González-Rodríguez, Eva M. Montalvá-Orón, Ángel Moya-Herraiz, Sandra Paterna-López, Miguel A. Suárez-Muñoz, Maialen Alkorta-Zuloaga, Gerardo Blanco-Fernández, Enrique Dabán-Collado, Miguel A. Gómez-Bravo, José I. Miota-de-Llamas, Fernando Rotellar, Belinda Sánchez-Pérez, Santiago Sánchez-Cabús, David Pacheco-Sánchez, Juan C. Rodríguez-Sanjuan, María A. Varona-Bosque, Lucía Carrión-Álvarez, Sofía de la Serna-Esteban, Cristina Dopazo, Elena Martín-Pérez, David Martínez-Cecilia, María J. Castro-Santiago, Dimitri Dorcaratto, Marta L. Gutiérrez-Díaz, José M. Asencio-Pascual, Fernando Burdío-Pinilla, Roberto Carracedo-Iglesias, Alfredo Escartín-Arias, Benedetto Ielpo, Gonzalo Rodríguez-Laiz, Andrés Valdivieso-López, Emilio De-Vicente-López, Vicente Alonso-Orduña and José M. Ramia Subject: (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. 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