34765
document
Influence of two different resection techniques ( conventional liver resection versus anterior approach ) of liver metastases from colorectal cancer on hematogenous tumor cell dissemination - prospective randomized multicenter trial . BACKGROUND Surgical hepatic resection remains the treatment of choice for patients with liver metastases from colorectal cancer despite the use of alternative therapeutic strategies . Although this procedure provides long-term survival in a significant number of patients , 50-75 % of the patients develop intra- and/or extrahepatic recurrence . One possible reason for tumor recurrence may be intraoperative hematogenous tumor cell dissemination due to mechanical manipulation of the tumor during hepatic resection . Surgical technique may have an influence on hematogenous tumor cell spread . We hypothesize that hematogenous tumor cell dissemination may be reduced by using the anterior approach technique compared to conventional liver resection . METHODS/DESIGN This is a multi-centre prospective randomized controlled , superiority trial to compare two liver resection techniques of liver metastases from colorectal cancer . 150 patients will be included and randomized intraoperatively after surgical exploration just prior to resection . The primary objective is to compare the anterior approach with the conventional liver resection technique with regard to intraoperative haematogenous tumor cell dissemination . As secondary objectives we examine five year survival rates ( OS and DFS ) , blood loss , duration of operation , requirement of blood transfusions , morbidity rate , prognostic relevance of tumor cell detection in blood and bone marrow and the comparison of tumor cell detection by different detection methods . CONCLUSION This trial will answer the question whether there is an advantage for the anterior approach technique compared to the conventional resection group with regard to tumor cell dissemination . It will also add further information about prognostic differences , safety , advantages and disadvantages of each technique . TRIAL REGISTRATION Current controlled trials - ISRCTN45066244 .
34766
Intervention_Surgical
conventional liver resection
34767
Intervention_Physical
anterior approach
34768
Intervention_Surgical
Surgical hepatic resection
34769
Intervention_Surgical
liver resection techniques of liver metastases
34770
Intervention_Physical
anterior approach
34771
Intervention_Surgical
conventional liver resection technique
34772
Intervention_Physical
anterior approach technique
34773
Intervention_Physical
conventional resection
34774
Outcome_Mortality
five year survival rates ( OS and DFS )
34775
Outcome_Physical
blood loss
34776
Outcome_Other
duration of operation
34777
Outcome_Other
requirement of blood transfusions
34778
Outcome_Mortality
morbidity rate
34779
Outcome_Other
prognostic relevance of tumor cell detection in blood and bone marrow