References of "POLUS, Marc"
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See detailLaparoscopic liver resection: monocentric university experience
Szecel, D.; ARENAS SANCHEZ, Maria Mara ULg; DE ROOVER, Arnaud ULg et al

in Acta Gastro-Enterologica Belgica (2011, March), 74(1), 30

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See detailFamilial adenomatous polyposis: clinical presentation, detection and surveillance.
Laurent, S.; Franchimont, D.; Vander Auwera, Jacqueline ULg et al

in Acta Gastro-Enterologica Belgica (2011), 74(3), 415-20

Colorectal cancer (CRC) is a leading cause of cancer related death in the western countries. It remains an important health problem, often under-diagnosed. The symptoms can appear very late and about 25 ... [more ▼]

Colorectal cancer (CRC) is a leading cause of cancer related death in the western countries. It remains an important health problem, often under-diagnosed. The symptoms can appear very late and about 25% of the patients are diagnosed at metastatic stage. Familial adenomatous polyposis (FAP) is an inherited colorectal cancer syndrome, characterized by the early onset of hundred to thousands of adenomatous polyps in the colon and rectum. Left untreated, there is a nearly 100% cumulative risk of progression to CRC by the age of 35-40 years, as well as an increased risk of various other malignancies. CRC can be prevented by the identification of the high risk population and by the timely implementation of rigid screening programs which will lead to special medico-surgical interventions. [less ▲]

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See detailEsophageal cancer surgery in patients older than 75: long term results.
HONORE, Charles ULg; Al-Azzeh, Ali ULg; GILSON, Nathalie ULg et al

in Acta Chirurgica Belgica (2011), 111(1), 12-7

PURPOSE: The purpose of this study was to evaluate short and long term results after esophageal cancer resection in patients older than 75. METHODS: We retrospectively analyzed the database of esophageal ... [more ▼]

PURPOSE: The purpose of this study was to evaluate short and long term results after esophageal cancer resection in patients older than 75. METHODS: We retrospectively analyzed the database of esophageal cancer surgically treated in our department between January 2003 and December 2009 to identify patients older than 75. The preoperative, operative, postoperative and long term characteristics were analyzed. RESULTS: Among 137 patient, 23 were older than 75. The histological subtype was adenocarcinoma in 100%. The surgical techniques were a "Lewis-Santy" procedure in 43%, a trans-hiatal resection in 22%, a "Sweet" procedure in 13%, a stripping in 13% and a McKeown procedure in 9%. The in-hospital postoperative mortality was 13%. The in-hospital postoperative morbidity (Dindo-Clavien Grade >2, deceased patients included) was 26%. In univariate analysis, no statistically significant risk factor of morbidity was found. A Charlson Comorbidity Index >2 was, in univariate analysis, the sole risk factor of postoperative mortality (p = 0.0362). The mean hospital stay was 22 +/- 12 days. The median survival was 24.2 months. The 5-year overall survival was 39% and the 5-year disease free survival was 26%.57% of long-term deaths were not cancer related. CONCLUSION: Esophageal surgery performed in selected patients older than 75 has an acceptable morbidity and mortality but when a severe complication occurs, it leads to death in half of the cases. Surgery enables a long term survival benefit. This study confirmed our attitude of not considering age as a contra-indication for esophageal surgery but rather considering general status, self-reliance and associated comorbidities for patients' selection. [less ▲]

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See detailAdjuvant gemcitabine alone versus gemcitabine-based chemoradiotherapy after curative resection for pancreatic cancer: a randomized EORTC-40013-22012/FFCD-9203/GERCOR phase II study.
Van Laethem, Jean*-Luc; Hammel, Pascal; Mornex, Francoise et al

in Journal of Clinical Oncology (2010), 28(29), 4450-6

PURPOSE: The role of adjuvant chemoradiotherapy (CRT) in resectable pancreatic cancer is still debated. This randomized phase II intergroup study explores the feasibility and tolerability of a gemcitabine ... [more ▼]

PURPOSE: The role of adjuvant chemoradiotherapy (CRT) in resectable pancreatic cancer is still debated. This randomized phase II intergroup study explores the feasibility and tolerability of a gemcitabine-based CRT regimen after R0 resection of pancreatic head cancer. PATIENTS AND METHODS: Within 8 weeks after surgery, patients were randomly assigned to receive either four cycles of gemcitabine (control arm) or gemcitabine for two cycles followed by weekly gemcitabine with concurrent radiation (50.4 Gy; CRT arm). The primary objective was to exclude a < 60% treatment completion and a > 40% rate of grade 4 hematologic or GI toxicity in the CRT arm with type I and II errors of 10%. Secondary end points were late toxicity, disease-free survival (DFS), and overall survival (OS). RESULTS: Between September 2004 and January 2007, 90 patients were randomly assigned (45:45). Patient characteristics were similar in both arms. Treatment was completed per protocol by 86.7% and 73.3% (80% CI, 63.1% to 81.9%; 95% CI, 58.1% to 85.4%) in the control and CRT arms, respectively, and grade 4 toxicity was 0% and 4.7% (two of 43; 80% CI, 1.2% to 11.9%), respectively. In the CRT arm, three patients experienced grade 3-related late toxicity. Median DFS was 12 months in the CRT arm and 11 months in the control arm. Median OS was 24 months in both arms. First local recurrence was less frequent in the CRT arm (11% v 24%). CONCLUSION: Adjuvant gemcitabine-based CRT is feasible, well-tolerated, and not deleterious; adding this treatment to full-dose adjuvant gemcitabine after resection of pancreatic cancer should be evaluated in a phase III trial. [less ▲]

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See detailDeoxycitidine kinase is associated with prolonged survival after adjuvant gemcitabine for resected pancreatic adenocarcinoma.
Marechal, Raphael; Mackey, John R; Lai, Raymond et al

in Cancer (2010), 116(22), 5200-6

BACKGROUND: Gemcitabine (2',2'-difluorodeoxycytidine) administration after resection of pancreatic cancer improves both disease-free survival (DFS) and overall survival (OS). Deoxycytidine kinase (dCK ... [more ▼]

BACKGROUND: Gemcitabine (2',2'-difluorodeoxycytidine) administration after resection of pancreatic cancer improves both disease-free survival (DFS) and overall survival (OS). Deoxycytidine kinase (dCK) mediates the rate-limiting catabolic step in the activation of gemcitabine. The authors of this report studied patient outcomes according to the expression of dCK after a postoperative gemcitabine-based chemoradiation regimen. METHODS: Forty-five patients with resected pancreatic adenocarcinoma received adjuvant gemcitabine based-therapy in the context of multicenter phase 2 studies. Their tumors were evaluated retrospectively for dCK protein expression by immunohistochemistry. A composite score based on the percentage of dCK-positive cancer cells and the intensity of staining was generated, and the results were dichotomized at the median values. RESULTS: The median follow-up was 19.95 months (95% confident interval [CI], 3.3-107.4 months). The lymph node (LN) ratio and dCK protein expression were significant predictors of DFS and OS in univariate analysis. On multivariate analysis, dCK protein expression was the only independent prognostic variable (DFS: hazard ratio [HR], 3.48; 95% CI, 1.66-7.31; P = .001; OS: HR, 3.2; 95% CI,1.44-7.13; P = .004). CONCLUSIONS: dCK protein expression was identified as an independent and strong prognostic factor in patients with resected pancreatic adenocarcinoma who received adjuvant gemcitabine therapy. The authors concluded that it deserves prospective evaluation as a predictive biomarker for patient selection. [less ▲]

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See detailL’étude du mois. Traitement de l’hépatocarcinome au stade palliatif par Sorafenib (Nexavar) :Résultats de l’étude SHARP (Sorafenib Hepatocarcinoma Assessment Randomized Protocol)
Detry, Olivier ULg; Delwaide, Jean ULg; Deroover, Arnaud ULg et al

in Revue Médicale de Liège (2009), 64(3), 168-170

Curative management of early-stage hepatocarcinoma may include partial hepatic resection, liver transplantation or tumoral necrosis using radiofrequency ablation or alcoholisation. Until recently, no ... [more ▼]

Curative management of early-stage hepatocarcinoma may include partial hepatic resection, liver transplantation or tumoral necrosis using radiofrequency ablation or alcoholisation. Until recently, no efficient therapeutic mean was available for advanced hepatocarcinoma. Sorafenib is a multikinase inhibitor that decreases tumoral proliferation and angiogenesis, and increases apoptosis in many cancer models. The results of a phase 3 randomized, multicentric, study, entitled SHARP, have now demonstrated that Sorafenib increases survival in patients with advanced hepatocarcinoma developed in Child A cirrhosis. Mean survival gain was a little less than 3 months, without any radiologic response or improvement in the delay before symptomatic progression of the disease. The monthly cost of Sorafenib is a little more than 5,000 euros. It is now crucial to evaluate the potential role of Sorafenib in adjuvant therapy after liver resection or radiofrequency ablation of hepatocarcinoma. The CHU of Liège is taking part to a randomized, multicentric study evaluating the use of Sorafenib after liver resection or radiofrequency ablation for hepatocarcinoma. Another future evaluation could be the association of Sorafenib with other antitumoral agents. [less ▲]

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See detailTraitement des carcinomes hépatocellulaires à un stade avancé
Van Daele, Daniel ULg; Belaiche, Jacques ULg; Delwaide, Jean ULg et al

in Revue Médicale de Liège (2009), 64(3), 140-147

Hepatocellular carcinoma is the main primitive tumor of the liver. It occurs in the setting of liver cirrhosis in more than 90% of the cases in developping countries. The prognosis depends on the size ... [more ▼]

Hepatocellular carcinoma is the main primitive tumor of the liver. It occurs in the setting of liver cirrhosis in more than 90% of the cases in developping countries. The prognosis depends on the size, number and extension of the tumor as well as on the severity of the underlying liver disease. The Barcelona Clinic Classification takes into account these different parameters and helps the clinician in the therapeutic decision. Some patients (around 25%) are amenable to therapy with a curative intent (liver transplantation, resection, destruction by radiofrequency). In patients with hepatocellular carcinoma at an intermediate stage, lipiodolized chemoembolization gives a survival advantage in comparison with placebo. No conventional regimen of chemotherapy has a proven survival benefit. In patients with a hepatocellular carcinoma at an advanced stage, sorafenib, an oral multi-targeted kinase inhibitor, is the first coumpound to demonstrate a significant effect on survival free of disease progression in a selected group of patients. Its toxicity profile is particularly favourable. Combination of surgical and medical therapies should be properly evaluated in clinical trials in the near future. [less ▲]

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See detailLe depistage generalise du cancer colorectal: une absolue necessite et une realite imminente en Communaute francaise.
Polus, Marc ULg; Montrieux, Christian ULg; Giet, Didier ULg et al

in Revue Médicale de Liège (2009), 64(2), 96-102

Colorectal cancer is a real problem of public health. Screening is an absolute necessity. An ambitious program of screening is launched in the French Community. Faecal occult blood test will be proposed ... [more ▼]

Colorectal cancer is a real problem of public health. Screening is an absolute necessity. An ambitious program of screening is launched in the French Community. Faecal occult blood test will be proposed to average risk patients in the general population. A total colonoscopy will be performed if FOBT is positive. First step colonoscopy will be proposed to high or very high risk patients. General practitioners are in the core of the multi-disciplinary program. [less ▲]

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See detailSurgical management of hepatic metastases of colorectal origin.
Gilson, Nathalie; Honore, Charles ULg; Detry, Olivier ULg et al

in Acta Gastro-Enterologica Belgica (2009), 72(3), 321-6

Colorectal cancer is the most frequent digestive cancer. Prognosis is greatly depending on the TNM stage at the time of diagnosis. Fifty percent of all patients shall develop, synchronously or ... [more ▼]

Colorectal cancer is the most frequent digestive cancer. Prognosis is greatly depending on the TNM stage at the time of diagnosis. Fifty percent of all patients shall develop, synchronously or metachronously, liver metastases. Different means such as chemotherapy, targeted therapies, radiofrequency ablation, portal vein embolization and two-stage hepatectomy may be used to make these metastases eventually resectable and to increase overall survival. This is a short review of these different methods used to increase resectability but also on the integration of these parameters in a larger approach of colorectal liver metastasis surgery especially insisting on multidisciplinary discussion. [less ▲]

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See detailQuand doit-on réséquer les métastases hépatiques d'un cancer colorectal?
Honoré, Charles ULg; Detry, Olivier ULg; Deroover, Arnaud ULg et al

in Revue Médicale de Liège (2008), 63(10), 595-599

6000 new cases of colorectal cancer are diagnosed each year in Belgium. 50% of these patients shall develop liver metastasis. Resection remains the only chance of long term survival and must be considered ... [more ▼]

6000 new cases of colorectal cancer are diagnosed each year in Belgium. 50% of these patients shall develop liver metastasis. Resection remains the only chance of long term survival and must be considered as an endpoint from the beginning of the treatment. It is the result of a multidisciplinary discussion and a global approach of the disease. It is rarely directly feasible, but there are many techniques which may make it achievable in the end. Today, resection criteria are exclusively technical and neitherbad prognosis factors, nor the presence of extra-hepatic metastases should exclude liver resection. This resecability must be assessed by a confirmed hepatobiliary surgeon and must be proposed to all patients whatever their age as long as their global status is good. [less ▲]

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See detailLe depistage du cancer colorectal
Piront, Patricia ULg; Louis, Edouard ULg; Belaiche, Jacques ULg et al

in Revue Médicale de Liège (2007), 62(1), 15-20

Colorectal cancer is the second leading cause of death in Northern countries and need a national screening program to reduce mortality and improve quality of life. Screening has to be cost-effective and ... [more ▼]

Colorectal cancer is the second leading cause of death in Northern countries and need a national screening program to reduce mortality and improve quality of life. Screening has to be cost-effective and acceptable for patients. Many screening tools, invasive or not, are existing and often debated: FOBT, sigmoidoscopy and complete colonoscopy. New tools are in development and have to be evaluated in current practice: virtual colonoscopy, new endoscopic technologies, DNA on faeces or proteomics with markers in serum. [less ▲]

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See detailScreening for colorectal cancer in 2006
Piront, Patricia ULg; Louis, Edouard ULg; Belaiche, Jacques ULg et al

in Acta Endoscopica (2007), 37(3), 305-313

Colorectal cancer is the second leading cause of death in Northern countries and needs a national screening program to reduce mortality and improve quality of life. Screening has to be cost-effective and ... [more ▼]

Colorectal cancer is the second leading cause of death in Northern countries and needs a national screening program to reduce mortality and improve quality of life. Screening has to be cost-effective and acceptable for patients. Many screening tools, invasive or not, are existing and often debated: FOBT, sigmoidoscopy and complete colonoscopy. New tools are in development and have to be evaluated in current practice: virtual colonoscopy, new endoscopic technologies, DNA on faeces or proteomics with markers in serum. [less ▲]

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See detailActualites therapeutiques en hepato-gastroenterologie
Belaiche, Jacques ULg; Delwaide, Jean ULg; Polus, Marc ULg et al

in Revue Médicale de Liège (2007), 62(5-6, May-Jun), 303-9

During the last decade, advances in molecular biology and biotechnology allowed, the development of biological treatments aimed at more precise targets. New algorithms in inflammatory bowel diseases ... [more ▼]

During the last decade, advances in molecular biology and biotechnology allowed, the development of biological treatments aimed at more precise targets. New algorithms in inflammatory bowel diseases, chronic hepatitis C and digestive oncology are examples of the marked progress achieved by these therapies. [less ▲]

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See detailActualites en chirurgie et transplantation hepatique
Detry, Olivier ULg; De Roover, Arnaud ULg; Coimbra Marques, Carla ULg et al

in Revue Médicale de Liège (2007), 62(5-6, May-Jun), 310-6

Over the last 20 years, significant improvements in hepatic surgery and transplantation have allowed better results. Better patients selection, new preoperative modalities aiming at modifying the volume ... [more ▼]

Over the last 20 years, significant improvements in hepatic surgery and transplantation have allowed better results. Better patients selection, new preoperative modalities aiming at modifying the volume of the liver or the tumour, new surgical techniques, and better postoperative management are the keys to improved outcome. These progresses are reviewed in this article. In hepatic surgery, the latest surgical improvements are the possibility of laparoscopic hepatic resection and of radiofrequency ablation. Modern neoadjuvant chemotherapy may in some cases allow a reduction of large liver colorectal metastases and render them resectable. Improved radiological techniques allow better planning of the surgical resections, reduction of the risks by calculation of the residual liver mass, and induction of liver hypertrophy by preoperative portal embolisation. In liver transplantation, the most significant changes were the use of living related liver donors and of non-heart beating donors to overcome the cadaveric organ donor shortage. [less ▲]

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See detailAdjuvant hyperthermic intraperitoneal peroperative chemotherapy (HIPEC) Associated with curative surgery for locally advanced gastric carcinoma.An initial experience
De Roover, Arnaud ULg; Detroz, Bernard ULg; Detry, Olivier ULg et al

in Acta Chirurgica Belgica (2006), 106(3), 297-301

Aim of the study : After macroscopic radical (R0) surgery for advanced gastric carcinoma, 40 to 50% of the tumors recur in the abdomen as locoregional or peritoneal disease. We initiated a protocol in ... [more ▼]

Aim of the study : After macroscopic radical (R0) surgery for advanced gastric carcinoma, 40 to 50% of the tumors recur in the abdomen as locoregional or peritoneal disease. We initiated a protocol in which patients with suspicion of macroscopic serosal, lymphatic or peritoneal invasion, treated with R0 resection, underwent adjuvant HIPEC. Methods : Between June 1998 and January 2003, 16 patients with locally advanced adenocarcinoma of the stomach were included in the study. Surgery consisted of a total gastrectomy with a D2 lymphadenectomy. Splenectomy (n = 1), splenopancreatectomy (n = 4), transverse colectomy (n = 3), left hepatectomy (n = 1), localized peritonectomy (n = 3) were associated to obtain a R0 resection. HIPEC protocol consisted of heated (42.5°C) intraperitoneal mitomycin C (15 mg/m2) for a planned duration of 90 minutes. Results : HIPEC median duration was limited to 73(20-90) min because of central hyperthermia recognition in half of the cases. One patient died in the postoperative period of sepsis secondary to a duodenal fistula. Postoperative morbidity included pancreatic fistula (n = 2), pulmonary oedema (n = 1), pulmonary embolus (n = 1) and transient renal failure (n = 1). UICC staging was IB (n = 2), II (n = 2), IIIA (n = 5), IIIB (n = 1), IV (n = 6). Nine of the 16 patients are alive without recurrence with a median follow-up of 52 months. Four patients developed a recurrence, intraperitoneal (n = 2), systemic (n = 1), or combined (n = 1). Two patients were lost to follow-up. Conclusions : Aggressive surgical therapy and HIPEC might represent the standard of care in a selected population with locoregional disease and for whom a R0 resection can be achieved. This protocol was associated in this study with a 75% 5-year survival with a low peritoneal recurrence rate and an acceptable morbidity. [less ▲]

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See detailCarcinoid tumor of the appendix: A consecutive series from 1237 appendectomies
Tchana-Sato, Vincent ULg; Detry, Olivier ULg; Polus, Marc ULg et al

in World Journal of Gastroenterology (2006), 12(41), 6699-6701

AIM: To report the experience of the CHU Sart Tilman, University of Liege, Belgium, in the management of appendiceal carinoid tumor. METHODS: A retrospective review of 1237 appendectomies performed in one ... [more ▼]

AIM: To report the experience of the CHU Sart Tilman, University of Liege, Belgium, in the management of appendiceal carinoid tumor. METHODS: A retrospective review of 1237 appendectomies performed in one single centre from January 2000 to May 2004, was undertaken. Analysis of demographic data, clinical presentation, histopathology, operative reports and outcome was presented. RESULTS: Among the 1237 appendectomies, 5 appendiceal carcinoid tumors were identified (0.4%) in 4 male and 1 female patients, with a mean age of 29.2 years (range: 6-82 years). Acute appendicitis was the clinical presentation for all patients. Four patients underwent open appendectomy and one a laparoscopic procedure. One patient was reoperated to complete the excision of mesoappendix. All tumors were located at the tip of the appendix with a mean diameter of 0.6 cm (range: 0.3-1.0 cm). No adjuvant therapy was performed. All patients were alive and disease-free during a mean follow-up of 33 mo. CONCLUSION: Appendiceal carcinoid tumor most often presents as appendicitis. In most cases, it is found incidentally during appendectomies and its diagnosis is rarely suspected before histological examination. Appendiceal carcinoid tumor can be managed by simple appendectomy and resection of the mesoappendix, if its size is <= 1 cm. (C) 2006 The WJG Press. All rights reserved. [less ▲]

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See detailClinicopathologic analysis of appendiceal tumors from 1,237 apendectomies
Tchanasato, V.; Laurent, S.; Thiry, Albert ULg et al

in Acta Gastro-Enterologica Belgica (2005, January), 68(1), 08

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See detailTraitement du cancer du sein chez la personne âgée
Gillain, Sophie ULg; Gennigens, Christine ULg; Sautois, Brieuc ULg et al

in Revue Médicale Suisse (2004), 62

Le cancer du sein représente chez la personne âgée une pathologie fréquente. Le choix du traitement dépend de l'âge physiologique, des pathologies et comorbidités associées ainsi que du niveau de vie et d ... [more ▼]

Le cancer du sein représente chez la personne âgée une pathologie fréquente. Le choix du traitement dépend de l'âge physiologique, des pathologies et comorbidités associées ainsi que du niveau de vie et d'autonomie. De plus, selon les facteurs histopronostiques (récepteurs aux oestrogènes et à la progestérone, la surexpression du cerb-B2) on décidera éventuellement du schéma thérapeutique le plus approprié. Chez la personne âgée, la chirurgie (mastectomie ou tumorectomie), la radiothérapie et l'hormonothérapie trouvent leur place. Au-delà de 70 ans, la place de la chimiothérapie est incertaine. En effet, les patientes de plus de 70 ans sont sous-représentées dans les études randomisées. [less ▲]

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See detailLiver resection for noncolorectal, nonneuroendocrine metastases
Detry, Olivier ULg; Warzee, Fabian ULg; Polus, Marc ULg et al

in Acta Chirurgica Belgica (2003), 103(5), 458-462

In noncolorectal, nonendocrine liver metastases, the role of surgery is less define than in colorectal or neuroendocrine cancer. This role is marginal as liver is not the primary site of metastases of ... [more ▼]

In noncolorectal, nonendocrine liver metastases, the role of surgery is less define than in colorectal or neuroendocrine cancer. This role is marginal as liver is not the primary site of metastases of these cancers. Less than 2 to 5% of the patients with these malignancies might be one day considered as potential candidates for liver resection, as most patients suffer from extra hepatic tumour spread at the time they develop liver involvement. However, in these few cases with liver metastases only, as no other therapeutic option may provide mid- or long-term tumour-free survival, liver resection is indicated in resectable liver metastases. Some prognostic factors have been established in the literature from the few published series : unique versus multiple hepatic metastases, unilobar vs bilobar, metachronous vs synchronous, R0 vs R1 or R2 liver resections. The type of primary tumour is also of great importance, as cutaneous melanoma, pancreatic and gastric adenocarcinoma have a very bad prognosis for liver resection of metastases, even after R0 resection. In these cases, percutaneous or laparoscopic radiofrequency ablation may find its place. In sarcoma, breast carcinoma, uveal melanoma, and genitourinary cancers, liver resection may provide satisfactory long-term results in selected cases, and is the standard of care for isolated, resectable metastasis. However, due to the scarcity of indication of liver resection for noncolorectal, nonneuroendocrine metastases, the decision should be multidisciplinary, and the patients should be informed of the advantages and pitfalls of the surgical procedure. [less ▲]

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