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Synchronous colorectal liver metastases in pregnancy and post‐partum
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| Zeitschriftentitel: | ANZ Journal of Surgery |
|---|---|
| Personen und Körperschaften: | , , , , |
| In: | ANZ Journal of Surgery, 87, 2017, 10, S. 800-804 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
Wiley
|
| Schlagwörter: |
| author_facet |
Robson, Danielle E. Lewin, Joel Cheng, Anthony W. O'Rourke, Nicholas A. Cavallucci, David J. Robson, Danielle E. Lewin, Joel Cheng, Anthony W. O'Rourke, Nicholas A. Cavallucci, David J. |
|---|---|
| author |
Robson, Danielle E. Lewin, Joel Cheng, Anthony W. O'Rourke, Nicholas A. Cavallucci, David J. |
| spellingShingle |
Robson, Danielle E. Lewin, Joel Cheng, Anthony W. O'Rourke, Nicholas A. Cavallucci, David J. ANZ Journal of Surgery Synchronous colorectal liver metastases in pregnancy and post‐partum General Medicine Surgery |
| author_sort |
robson, danielle e. |
| spelling |
Robson, Danielle E. Lewin, Joel Cheng, Anthony W. O'Rourke, Nicholas A. Cavallucci, David J. 1445-1433 1445-2197 Wiley General Medicine Surgery http://dx.doi.org/10.1111/ans.13196 <jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Metastatic colorectal cancer (m<jats:styled-content style="fixed-case">CRC</jats:styled-content>) in pregnancy and post‐partum is rare, but represents significant diagnostic and therapeutic challenges for clinicians. A multidisciplinary team (<jats:styled-content style="fixed-case">MDT</jats:styled-content>) approach is essential. This study reports the first series in the Australasian literature, describing our experience with and management of pregnant and post‐partum patients diagnosed with synchronous colorectal liver metastases (s<jats:styled-content style="fixed-case">CRLM</jats:styled-content>).</jats:p></jats:sec><jats:sec><jats:title>Method</jats:title><jats:p>A retrospective review of prospectively collected data for patients with s<jats:styled-content style="fixed-case">CRLM</jats:styled-content> diagnosed during pregnancy or post‐partum, presenting to a tertiary referral hospital between 2009 and 2014, was performed. Data regarding patient presentation, imaging, management, histopathology and survival were analysed. Patient characteristics and outcomes were reviewed, including age, presenting complaint and median survival.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Five patients were identified with s<jats:styled-content style="fixed-case">CRLM</jats:styled-content>: three patients were diagnosed antepartum and two post‐partum. Median age was 31 years (range 26–34). All patients were diagnosed with colorectal primary and synchronous liver lesions. All patients received folinic acid, fluorouracil, oxaliplatin chemotherapy, two intrapartum. One patient had both the primary lesion and liver metastases excised early post‐partum. Second‐line chemotherapy with folinic acid, fluorouracil, irinotecan and other biological agents was used in some cases post‐partum. One patient suffered a fetal loss, while the other four had uncomplicated live births. Median survival was 7.6 months, with two patients dying shortly after delivery.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The diagnosis of m<jats:styled-content style="fixed-case">CRC</jats:styled-content> in pregnancy is challenging and survival is poor. A <jats:styled-content style="fixed-case">MDT</jats:styled-content> approach to management is essential. Chemotherapy remains the mainstay of treatment from the second trimester. Rapid confirmation of diagnosis and early chemotherapy, followed by post‐partum colorectal and liver resection may improve survival.</jats:p></jats:sec> Synchronous colorectal liver metastases in pregnancy and post‐partum ANZ Journal of Surgery |
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| title |
Synchronous colorectal liver metastases in pregnancy and post‐partum |
| title_unstemmed |
Synchronous colorectal liver metastases in pregnancy and post‐partum |
| title_full |
Synchronous colorectal liver metastases in pregnancy and post‐partum |
| title_fullStr |
Synchronous colorectal liver metastases in pregnancy and post‐partum |
| title_full_unstemmed |
Synchronous colorectal liver metastases in pregnancy and post‐partum |
| title_short |
Synchronous colorectal liver metastases in pregnancy and post‐partum |
| title_sort |
synchronous colorectal liver metastases in pregnancy and post‐partum |
| topic |
General Medicine Surgery |
| url |
http://dx.doi.org/10.1111/ans.13196 |
| publishDate |
2017 |
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800-804 |
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<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Metastatic colorectal cancer (m<jats:styled-content style="fixed-case">CRC</jats:styled-content>) in pregnancy and post‐partum is rare, but represents significant diagnostic and therapeutic challenges for clinicians. A multidisciplinary team (<jats:styled-content style="fixed-case">MDT</jats:styled-content>) approach is essential. This study reports the first series in the Australasian literature, describing our experience with and management of pregnant and post‐partum patients diagnosed with synchronous colorectal liver metastases (s<jats:styled-content style="fixed-case">CRLM</jats:styled-content>).</jats:p></jats:sec><jats:sec><jats:title>Method</jats:title><jats:p>A retrospective review of prospectively collected data for patients with s<jats:styled-content style="fixed-case">CRLM</jats:styled-content> diagnosed during pregnancy or post‐partum, presenting to a tertiary referral hospital between 2009 and 2014, was performed. Data regarding patient presentation, imaging, management, histopathology and survival were analysed. Patient characteristics and outcomes were reviewed, including age, presenting complaint and median survival.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Five patients were identified with s<jats:styled-content style="fixed-case">CRLM</jats:styled-content>: three patients were diagnosed antepartum and two post‐partum. Median age was 31 years (range 26–34). All patients were diagnosed with colorectal primary and synchronous liver lesions. All patients received folinic acid, fluorouracil, oxaliplatin chemotherapy, two intrapartum. One patient had both the primary lesion and liver metastases excised early post‐partum. Second‐line chemotherapy with folinic acid, fluorouracil, irinotecan and other biological agents was used in some cases post‐partum. One patient suffered a fetal loss, while the other four had uncomplicated live births. Median survival was 7.6 months, with two patients dying shortly after delivery.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The diagnosis of m<jats:styled-content style="fixed-case">CRC</jats:styled-content> in pregnancy is challenging and survival is poor. A <jats:styled-content style="fixed-case">MDT</jats:styled-content> approach to management is essential. Chemotherapy remains the mainstay of treatment from the second trimester. Rapid confirmation of diagnosis and early chemotherapy, followed by post‐partum colorectal and liver resection may improve survival.</jats:p></jats:sec> |
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| author | Robson, Danielle E., Lewin, Joel, Cheng, Anthony W., O'Rourke, Nicholas A., Cavallucci, David J. |
| author_facet | Robson, Danielle E., Lewin, Joel, Cheng, Anthony W., O'Rourke, Nicholas A., Cavallucci, David J., Robson, Danielle E., Lewin, Joel, Cheng, Anthony W., O'Rourke, Nicholas A., Cavallucci, David J. |
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| description | <jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Metastatic colorectal cancer (m<jats:styled-content style="fixed-case">CRC</jats:styled-content>) in pregnancy and post‐partum is rare, but represents significant diagnostic and therapeutic challenges for clinicians. A multidisciplinary team (<jats:styled-content style="fixed-case">MDT</jats:styled-content>) approach is essential. This study reports the first series in the Australasian literature, describing our experience with and management of pregnant and post‐partum patients diagnosed with synchronous colorectal liver metastases (s<jats:styled-content style="fixed-case">CRLM</jats:styled-content>).</jats:p></jats:sec><jats:sec><jats:title>Method</jats:title><jats:p>A retrospective review of prospectively collected data for patients with s<jats:styled-content style="fixed-case">CRLM</jats:styled-content> diagnosed during pregnancy or post‐partum, presenting to a tertiary referral hospital between 2009 and 2014, was performed. Data regarding patient presentation, imaging, management, histopathology and survival were analysed. Patient characteristics and outcomes were reviewed, including age, presenting complaint and median survival.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Five patients were identified with s<jats:styled-content style="fixed-case">CRLM</jats:styled-content>: three patients were diagnosed antepartum and two post‐partum. Median age was 31 years (range 26–34). All patients were diagnosed with colorectal primary and synchronous liver lesions. All patients received folinic acid, fluorouracil, oxaliplatin chemotherapy, two intrapartum. One patient had both the primary lesion and liver metastases excised early post‐partum. Second‐line chemotherapy with folinic acid, fluorouracil, irinotecan and other biological agents was used in some cases post‐partum. One patient suffered a fetal loss, while the other four had uncomplicated live births. Median survival was 7.6 months, with two patients dying shortly after delivery.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The diagnosis of m<jats:styled-content style="fixed-case">CRC</jats:styled-content> in pregnancy is challenging and survival is poor. A <jats:styled-content style="fixed-case">MDT</jats:styled-content> approach to management is essential. Chemotherapy remains the mainstay of treatment from the second trimester. Rapid confirmation of diagnosis and early chemotherapy, followed by post‐partum colorectal and liver resection may improve survival.</jats:p></jats:sec> |
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| spelling | Robson, Danielle E. Lewin, Joel Cheng, Anthony W. O'Rourke, Nicholas A. Cavallucci, David J. 1445-1433 1445-2197 Wiley General Medicine Surgery http://dx.doi.org/10.1111/ans.13196 <jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Metastatic colorectal cancer (m<jats:styled-content style="fixed-case">CRC</jats:styled-content>) in pregnancy and post‐partum is rare, but represents significant diagnostic and therapeutic challenges for clinicians. A multidisciplinary team (<jats:styled-content style="fixed-case">MDT</jats:styled-content>) approach is essential. This study reports the first series in the Australasian literature, describing our experience with and management of pregnant and post‐partum patients diagnosed with synchronous colorectal liver metastases (s<jats:styled-content style="fixed-case">CRLM</jats:styled-content>).</jats:p></jats:sec><jats:sec><jats:title>Method</jats:title><jats:p>A retrospective review of prospectively collected data for patients with s<jats:styled-content style="fixed-case">CRLM</jats:styled-content> diagnosed during pregnancy or post‐partum, presenting to a tertiary referral hospital between 2009 and 2014, was performed. Data regarding patient presentation, imaging, management, histopathology and survival were analysed. Patient characteristics and outcomes were reviewed, including age, presenting complaint and median survival.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Five patients were identified with s<jats:styled-content style="fixed-case">CRLM</jats:styled-content>: three patients were diagnosed antepartum and two post‐partum. Median age was 31 years (range 26–34). All patients were diagnosed with colorectal primary and synchronous liver lesions. All patients received folinic acid, fluorouracil, oxaliplatin chemotherapy, two intrapartum. One patient had both the primary lesion and liver metastases excised early post‐partum. Second‐line chemotherapy with folinic acid, fluorouracil, irinotecan and other biological agents was used in some cases post‐partum. One patient suffered a fetal loss, while the other four had uncomplicated live births. Median survival was 7.6 months, with two patients dying shortly after delivery.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The diagnosis of m<jats:styled-content style="fixed-case">CRC</jats:styled-content> in pregnancy is challenging and survival is poor. A <jats:styled-content style="fixed-case">MDT</jats:styled-content> approach to management is essential. Chemotherapy remains the mainstay of treatment from the second trimester. Rapid confirmation of diagnosis and early chemotherapy, followed by post‐partum colorectal and liver resection may improve survival.</jats:p></jats:sec> Synchronous colorectal liver metastases in pregnancy and post‐partum ANZ Journal of Surgery |
| spellingShingle | Robson, Danielle E., Lewin, Joel, Cheng, Anthony W., O'Rourke, Nicholas A., Cavallucci, David J., ANZ Journal of Surgery, Synchronous colorectal liver metastases in pregnancy and post‐partum, General Medicine, Surgery |
| title | Synchronous colorectal liver metastases in pregnancy and post‐partum |
| title_full | Synchronous colorectal liver metastases in pregnancy and post‐partum |
| title_fullStr | Synchronous colorectal liver metastases in pregnancy and post‐partum |
| title_full_unstemmed | Synchronous colorectal liver metastases in pregnancy and post‐partum |
| title_short | Synchronous colorectal liver metastases in pregnancy and post‐partum |
| title_sort | synchronous colorectal liver metastases in pregnancy and post‐partum |
| title_unstemmed | Synchronous colorectal liver metastases in pregnancy and post‐partum |
| topic | General Medicine, Surgery |
| url | http://dx.doi.org/10.1111/ans.13196 |