Cancers (Jul 2020)
Resectability and Ablatability Criteria for the Treatment of Liver Only Colorectal Metastases: Multidisciplinary Consensus Document from the COLLISION Trial Group
- Sanne Nieuwenhuizen,
- Robbert S. Puijk,
- Bente van den Bemd,
- Luca Aldrighetti,
- Mark Arntz,
- Peter B. van den Boezem,
- Anna M. E. Bruynzeel,
- Mark C. Burgmans,
- Francesco de Cobelli,
- Marielle M. E. Coolsen,
- Cornelis H. C. Dejong,
- Sarah Derks,
- Arjen Diederik,
- Peter van Duijvendijk,
- Hasan H. Eker,
- Anton F. Engelsman,
- Joris I. Erdmann,
- Jurgen J. Fütterer,
- Bart Geboers,
- Gerie Groot,
- Cornelis J. A. Haasbeek,
- Jan-Jaap Janssen,
- Koert P. de Jong,
- G. Matthijs Kater,
- Geert Kazemier,
- Johan W. H. Kruimer,
- Wouter K. G. Leclercq,
- Christiaan van der Leij,
- Eric R. Manusama,
- Mark A. J. Meier,
- Bram B. van der Meijs,
- Marleen C. A. M. Melenhorst,
- Karin Nielsen,
- Maarten W. Nijkamp,
- Fons H. Potters,
- Warner Prevoo,
- Floris J. Rietema,
- Alette H. Ruarus,
- Simeon J. S. Ruiter,
- Evelien A. C. Schouten,
- Gian Piero Serafino,
- Colin Sietses,
- Rutger-Jan Swijnenburg,
- Florentine E. F. Timmer,
- Kathelijn S. Versteeg,
- Ted Vink,
- Jan J. J. de Vries,
- Johannes H. W. de Wilt,
- Barbara M. Zonderhuis,
- Hester J. Scheffer,
- Petrousjka M. P. van den Tol,
- Martijn R. Meijerink
Affiliations
- Sanne Nieuwenhuizen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location VUmc, 1081 HV Amsterdam, The Netherlands
- Robbert S. Puijk
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location VUmc, 1081 HV Amsterdam, The Netherlands
- Bente van den Bemd
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location VUmc, 1081 HV Amsterdam, The Netherlands
- Luca Aldrighetti
- Department of Surgical Oncology, San Raffaele Hospital, 20132 Milan, Italy
- Mark Arntz
- Department of Radiology, Nuclear Medicine and Anatomy, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Peter B. van den Boezem
- Department of Surgical Oncology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Anna M. E. Bruynzeel
- Department of Radiation Oncology, Amsterdam UMC, location VUmc, 1081 HV Amsterdam, The Netherlands
- Mark C. Burgmans
- Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Francesco de Cobelli
- Department of Radiology, San Raffaele Hospital, 20132 Milan, Italy
- Marielle M. E. Coolsen
- Department of Surgical Oncology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
- Cornelis H. C. Dejong
- Department of Surgical Oncology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
- Sarah Derks
- Department of Medical Oncology, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands; Oncode Institute, 3521 AL Utrecht, The Netherlands
- Arjen Diederik
- Department of Radiology, Ziekenhuis Gelderse Vallei, 6716 RP Ede, The Netherlands
- Peter van Duijvendijk
- Department of Surgical Oncology, Gelre Ziekenhuizen, 7334 DZ Apeldoorn, The Netherlands
- Hasan H. Eker
- Department of Surgical Oncology, Medical Center Leeuwarden, 8934 AD Leeuwarden, The Netherlands
- Anton F. Engelsman
- Department of Surgical Oncology, Amsterdam UMC, location VUmc, 1081 HV Amsterdam, The Netherlands
- Joris I. Erdmann
- Department of Surgical Oncology, Amsterdam UMC, location VUmc, 1081 HV Amsterdam, The Netherlands
- Jurgen J. Fütterer
- Department of Radiology, Nuclear Medicine and Anatomy, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Bart Geboers
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location VUmc, 1081 HV Amsterdam, The Netherlands
- Gerie Groot
- Department of Radiology, Ziekenhuis Gelderse Vallei, 6716 RP Ede, The Netherlands
- Cornelis J. A. Haasbeek
- Department of Radiation Oncology, Amsterdam UMC, location VUmc, 1081 HV Amsterdam, The Netherlands
- Jan-Jaap Janssen
- Department of Radiology, Nuclear Medicine and Anatomy, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Koert P. de Jong
- Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
- G. Matthijs Kater
- Department of Radiology, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
- Geert Kazemier
- Department of Surgical Oncology, Amsterdam UMC, location VUmc, 1081 HV Amsterdam, The Netherlands
- Johan W. H. Kruimer
- Department of Radiology, Maxima Medical Center, 5504 DB Veldhoven, The Netherlands
- Wouter K. G. Leclercq
- Department of Surgical Oncology, Maxima Medical Center, 5504 DB Veldhoven, The Netherlands
- Christiaan van der Leij
- Department of Radiology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
- Eric R. Manusama
- Department of Surgical Oncology, Medical Center Leeuwarden, 8934 AD Leeuwarden, The Netherlands
- Mark A. J. Meier
- Department of Radiology, Isala Ziekenhuis, 8025 AB Zwolle, The Netherlands
- Bram B. van der Meijs
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location VUmc, 1081 HV Amsterdam, The Netherlands
- Marleen C. A. M. Melenhorst
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location VUmc, 1081 HV Amsterdam, The Netherlands
- Karin Nielsen
- Department of Surgical Oncology, Amsterdam UMC, location VUmc, 1081 HV Amsterdam, The Netherlands
- Maarten W. Nijkamp
- Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
- Fons H. Potters
- Department of Radiology, Isala Ziekenhuis, 8025 AB Zwolle, The Netherlands
- Warner Prevoo
- Department of Radiology, OLVG, 1090 HM Amsterdam, The Netherlands
- Floris J. Rietema
- Department of Radiology, Noordwest Ziekenhuisgroep, 1815 JD Alkmaar, The Netherlands
- Alette H. Ruarus
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location VUmc, 1081 HV Amsterdam, The Netherlands
- Simeon J. S. Ruiter
- Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
- Evelien A. C. Schouten
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location VUmc, 1081 HV Amsterdam, The Netherlands
- Gian Piero Serafino
- Department of Radiology, Jeroen Bosch Ziekenhuis, 5223 GZ ‘s-Hertogenbosch, The Netherlands
- Colin Sietses
- Department of Surgical Oncology, Ziekenhuis Gelderse Vallei, 6716 RP Ede, The Netherlands
- Rutger-Jan Swijnenburg
- Department of Surgical Oncology, Amsterdam UMC, location VUmc, 1081 HV Amsterdam, The Netherlands
- Florentine E. F. Timmer
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location VUmc, 1081 HV Amsterdam, The Netherlands
- Kathelijn S. Versteeg
- Department of Medical Oncology, Amsterdam UMC, location VUmc, 1081 HV Amsterdam, The Netherlands
- Ted Vink
- Department of Radiology, Medical Center Leeuwarden, 8934 AD Leeuwarden, The Netherlands
- Jan J. J. de Vries
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location VUmc, 1081 HV Amsterdam, The Netherlands
- Johannes H. W. de Wilt
- Department of Surgical Oncology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Barbara M. Zonderhuis
- Department of Surgical Oncology, Amsterdam UMC, location VUmc, 1081 HV Amsterdam, The Netherlands
- Hester J. Scheffer
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location VUmc, 1081 HV Amsterdam, The Netherlands
- Petrousjka M. P. van den Tol
- Department of Surgical Oncology, Amsterdam UMC, location VUmc, 1081 HV Amsterdam, The Netherlands
- Martijn R. Meijerink
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location VUmc, 1081 HV Amsterdam, The Netherlands
- DOI
- https://doi.org/10.3390/cancers12071779
- Journal volume & issue
-
Vol. 12,
no. 7
p. 1779
Abstract
The guidelines for metastatic colorectal cancer crudely state that the best local treatment should be selected from a ‘toolbox’ of techniques according to patient- and treatment-related factors. We created an interdisciplinary, consensus-based algorithm with specific resectability and ablatability criteria for the treatment of colorectal liver metastases (CRLM). To pursue consensus, members of the multidisciplinary COLLISION and COLDFIRE trial expert panel employed the RAND appropriateness method (RAM). Statements regarding patient, disease, tumor and treatment characteristics were categorized as appropriate, equipoise or inappropriate. Patients with ECOG≤2, ASA≤3 and Charlson comorbidity index ≤8 should be considered fit for curative-intent local therapy. When easily resectable and/or ablatable (stage IVa), (neo)adjuvant systemic therapy is not indicated. When requiring major hepatectomy (stage IVb), neo-adjuvant systemic therapy is appropriate for early metachronous disease and to reduce procedural risk. To downstage patients (stage IVc), downsizing induction systemic therapy and/or future remnant augmentation is advised. Disease can only be deemed permanently unsuitable for local therapy if downstaging failed (stage IVd). Liver resection remains the gold standard. Thermal ablation is reserved for unresectable CRLM, deep-seated resectable CRLM and can be considered when patients are in poor health. Irreversible electroporation and stereotactic body radiotherapy can be considered for unresectable perihilar and perivascular CRLM 0-5cm. This consensus document provides per-patient and per-tumor resectability and ablatability criteria for the treatment of CRLM. These criteria are intended to aid tumor board discussions, improve consistency when designing prospective trials and advance intersociety communications. Areas where consensus is lacking warrant future comparative studies.
Keywords
- colorectal liver metastases
- thermal ablation
- microwave ablation
- radiofrequency ablation
- partial hepatectomy
- irreversible electroporation