Resectability assessment of colorectal liver metastases by an expert panel: Potential impact on hospitals referring patients for local treatment

Marinde J G Bond; Cornelis Verhoef; Geert Kazemier; Niels F M Kok; Michael F Gerhards; Koert F D Kuhlmann; Wouter K G Leclercq; Arjen M Rijken; Mike S L Liem; Johannes H W de Wilt; Joost M Klaase; Thiery Chapelle; Dirk J Grünhagen; I Quintus Molenaar; Ronald R M van Dam; Anne M May; Cornelis J A Punt; Rutger-Jan Swijnenburg

doi:10.1016/j.ejso.2025.109681

Resectability assessment of colorectal liver metastases by an expert panel: Potential impact on hospitals referring patients for local treatment

Marinde J G Bond, Cornelis Verhoef, Geert Kazemier, Niels F M Kok, Michael F Gerhards, Koert F D Kuhlmann, Wouter K G Leclercq, Arjen M Rijken, Mike S L Liem, Johannes H W de Wilt, Joost M Klaase, Thiery Chapelle, Dirk J Grünhagen, I Quintus Molenaar, Ronald R M van Dam, Anne M May, Cornelis J A Punt, Rutger-Jan Swijnenburg

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: Patients with colorectal liver-only metastases (CRLM) eligible for local treatment (resection/ablation) do not always receive this potentially curative treatment due to the lack of clear resectability criteria and expertise in centres not performing liver surgery. We evaluated the potential value of a liver expert panel in daily practice.

METHODS: All patients with CRLM starting with systemic treatment in centres not performing liver surgery between 2016 and 2020 were identified in the Netherlands Cancer Registry. A panel of liver surgeons retrospectively re-evaluated patients' imaging for resectability before and two-monthly during systemic treatment.

RESULTS: Sixty-three patients were included from 24 hospitals requiring a total of 544 resectability assessments by individual panel surgeons. The panel considered 18 (29 %) patients to have resectable CRLM before starting systemic treatment, which increased to 43 (68 %) after up to three evaluations. Eighteen (29 %) patients considered resectable by the panel at any time received no local treatment of whom 9 (50 %) were not referred to a liver surgeon.

CONCLUSION: In non-liver-surgery centres, over a quarter of patients technically eligible for local treatment of initially unresectable CRLM, sometimes mistakenly categorised as such, did not receive this. This stresses the need for liver expert panels in daily practice to increase local treatment rates.

Original language	English
Pages (from-to)	109681
Journal	European Journal of Surgical Oncology
Volume	51
Issue number	6
DOIs	https://doi.org/10.1016/j.ejso.2025.109681
Publication status	E-pub ahead of print - 10-Feb-2025

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Resectability assessment of colorectal liver metastases by an expert panel
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Bond, M. J. G., Verhoef, C., Kazemier, G., Kok, N. F. M., Gerhards, M. F., Kuhlmann, K. F. D., Leclercq, W. K. G., Rijken, A. M., Liem, M. S. L., de Wilt, J. H. W., Klaase, J. M., Chapelle, T., Grünhagen, D. J., Molenaar, I. Q., van Dam, R. R. M., May, A. M., Punt, C. J. A., & Swijnenburg, R.-J. (2025). Resectability assessment of colorectal liver metastases by an expert panel: Potential impact on hospitals referring patients for local treatment. European Journal of Surgical Oncology, 51(6), 109681. Advance online publication. https://doi.org/10.1016/j.ejso.2025.109681

@article{86fd1d2c3235447599657d08dbe295a2,

title = "Resectability assessment of colorectal liver metastases by an expert panel: Potential impact on hospitals referring patients for local treatment",

abstract = "BACKGROUND: Patients with colorectal liver-only metastases (CRLM) eligible for local treatment (resection/ablation) do not always receive this potentially curative treatment due to the lack of clear resectability criteria and expertise in centres not performing liver surgery. We evaluated the potential value of a liver expert panel in daily practice.METHODS: All patients with CRLM starting with systemic treatment in centres not performing liver surgery between 2016 and 2020 were identified in the Netherlands Cancer Registry. A panel of liver surgeons retrospectively re-evaluated patients' imaging for resectability before and two-monthly during systemic treatment.RESULTS: Sixty-three patients were included from 24 hospitals requiring a total of 544 resectability assessments by individual panel surgeons. The panel considered 18 (29 %) patients to have resectable CRLM before starting systemic treatment, which increased to 43 (68 %) after up to three evaluations. Eighteen (29 %) patients considered resectable by the panel at any time received no local treatment of whom 9 (50 %) were not referred to a liver surgeon.CONCLUSION: In non-liver-surgery centres, over a quarter of patients technically eligible for local treatment of initially unresectable CRLM, sometimes mistakenly categorised as such, did not receive this. This stresses the need for liver expert panels in daily practice to increase local treatment rates.",

author = "Bond, {Marinde J G} and Cornelis Verhoef and Geert Kazemier and Kok, {Niels F M} and Gerhards, {Michael F} and Kuhlmann, {Koert F D} and Leclercq, {Wouter K G} and Rijken, {Arjen M} and Liem, {Mike S L} and {de Wilt}, {Johannes H W} and Klaase, {Joost M} and Thiery Chapelle and Gr{\"u}nhagen, {Dirk J} and Molenaar, {I Quintus} and {van Dam}, {Ronald R M} and May, {Anne M} and Punt, {Cornelis J A} and Rutger-Jan Swijnenburg",

note = "Copyright {\textcopyright} 2025. Published by Elsevier Ltd.",

year = "2025",

month = feb,

day = "10",

doi = "10.1016/j.ejso.2025.109681",

language = "English",

volume = "51",

pages = "109681",

journal = "European Journal of Surgical Oncology",

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Bond, MJG, Verhoef, C, Kazemier, G, Kok, NFM, Gerhards, MF, Kuhlmann, KFD, Leclercq, WKG, Rijken, AM, Liem, MSL, de Wilt, JHW, Klaase, JM, Chapelle, T, Grünhagen, DJ, Molenaar, IQ, van Dam, RRM, May, AM, Punt, CJA & Swijnenburg, R-J 2025, 'Resectability assessment of colorectal liver metastases by an expert panel: Potential impact on hospitals referring patients for local treatment', European Journal of Surgical Oncology, vol. 51, no. 6, pp. 109681. https://doi.org/10.1016/j.ejso.2025.109681

Resectability assessment of colorectal liver metastases by an expert panel: Potential impact on hospitals referring patients for local treatment. / Bond, Marinde J G; Verhoef, Cornelis; Kazemier, Geert et al.
In: European Journal of Surgical Oncology, Vol. 51, No. 6, 10.02.2025, p. 109681.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Resectability assessment of colorectal liver metastases by an expert panel

T2 - Potential impact on hospitals referring patients for local treatment

AU - Bond, Marinde J G

AU - Verhoef, Cornelis

AU - Kazemier, Geert

AU - Kok, Niels F M

AU - Gerhards, Michael F

AU - Kuhlmann, Koert F D

AU - Leclercq, Wouter K G

AU - Rijken, Arjen M

AU - Liem, Mike S L

AU - de Wilt, Johannes H W

AU - Klaase, Joost M

AU - Chapelle, Thiery

AU - Grünhagen, Dirk J

AU - Molenaar, I Quintus

AU - van Dam, Ronald R M

AU - May, Anne M

AU - Punt, Cornelis J A

AU - Swijnenburg, Rutger-Jan

PY - 2025/2/10

Y1 - 2025/2/10

N2 - BACKGROUND: Patients with colorectal liver-only metastases (CRLM) eligible for local treatment (resection/ablation) do not always receive this potentially curative treatment due to the lack of clear resectability criteria and expertise in centres not performing liver surgery. We evaluated the potential value of a liver expert panel in daily practice.METHODS: All patients with CRLM starting with systemic treatment in centres not performing liver surgery between 2016 and 2020 were identified in the Netherlands Cancer Registry. A panel of liver surgeons retrospectively re-evaluated patients' imaging for resectability before and two-monthly during systemic treatment.RESULTS: Sixty-three patients were included from 24 hospitals requiring a total of 544 resectability assessments by individual panel surgeons. The panel considered 18 (29 %) patients to have resectable CRLM before starting systemic treatment, which increased to 43 (68 %) after up to three evaluations. Eighteen (29 %) patients considered resectable by the panel at any time received no local treatment of whom 9 (50 %) were not referred to a liver surgeon.CONCLUSION: In non-liver-surgery centres, over a quarter of patients technically eligible for local treatment of initially unresectable CRLM, sometimes mistakenly categorised as such, did not receive this. This stresses the need for liver expert panels in daily practice to increase local treatment rates.

AB - BACKGROUND: Patients with colorectal liver-only metastases (CRLM) eligible for local treatment (resection/ablation) do not always receive this potentially curative treatment due to the lack of clear resectability criteria and expertise in centres not performing liver surgery. We evaluated the potential value of a liver expert panel in daily practice.METHODS: All patients with CRLM starting with systemic treatment in centres not performing liver surgery between 2016 and 2020 were identified in the Netherlands Cancer Registry. A panel of liver surgeons retrospectively re-evaluated patients' imaging for resectability before and two-monthly during systemic treatment.RESULTS: Sixty-three patients were included from 24 hospitals requiring a total of 544 resectability assessments by individual panel surgeons. The panel considered 18 (29 %) patients to have resectable CRLM before starting systemic treatment, which increased to 43 (68 %) after up to three evaluations. Eighteen (29 %) patients considered resectable by the panel at any time received no local treatment of whom 9 (50 %) were not referred to a liver surgeon.CONCLUSION: In non-liver-surgery centres, over a quarter of patients technically eligible for local treatment of initially unresectable CRLM, sometimes mistakenly categorised as such, did not receive this. This stresses the need for liver expert panels in daily practice to increase local treatment rates.

U2 - 10.1016/j.ejso.2025.109681

DO - 10.1016/j.ejso.2025.109681

M3 - Article

C2 - 40014958

SN - 0748-7983

VL - 51

SP - 109681

JO - European Journal of Surgical Oncology

JF - European Journal of Surgical Oncology

IS - 6

ER -

Resectability assessment of colorectal liver metastases by an expert panel: Potential impact on hospitals referring patients for local treatment

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