LIVACOR Trial: Minimally Invasive LIVer And Simultaneous COlorectal Resection (LIVACOR)
Colorectal Neoplasms Malignant, Neoplasm Metastasis
About this trial
This is an interventional treatment trial for Colorectal Neoplasms Malignant
Eligibility Criteria
Inclusion Criteria:
- ≥ 18 years
- Diagnosed with primary CRC with resectable synchronous CRLMs (with or without neoadjuvant chemotherapy)*
- Elective indication for MI combined or staged colorectal resection (all colectomies, including high anterior resection) and liver resection of up to 3 segments with a maximum of 2 separate liver resections. The MI two-staged approach includes both the conventional strategy (first resection of primary colorectal tumor followed by liver resection for CRLMs) and liver-first strategy (first CRLMs resection followed by resection of colorectal primary tumor). Patients undergoing bilobar resections are eligible (if 3 or fewer segments are resected)
- BMI between and including 18-35
Patients with American Society of Anesthesiologists (ASA) physical status I-III and the American College of Surgeons national surgical quality improvement project (ACS NSQIP) universal surgical risk score of ≤ 50% for serious complications
- In case of neoadjuvant chemotherapy, time interval between last chemotherapy cycle and (first) surgery should be 4-6 weeks.
Exclusion Criteria:
- Inability to give (written) informed consent.
- Patients requiring a planned temporarily or permanent stoma after colorectal resection (all colectomies, including high anterior resection). Patients who will receive an unplanned stoma intraoperatively, will be analysed according to their initial treatment assignment.
- Patients requiring multivisceral colorectal resection (all colectomies, including high anterior resection).
- Indication for MI combined or staged low anterior resection, total mesorectal excision or abdominoperineal resection and liver resection of four or more segments (i.e., hemihepatectomy or more extensive resections).
- Patients with peritoneal metastases.
- Patients with ASA physical status IV-V and ACS NSQIP surgical risk score of > 50% for serious complications.
- Repeat open hepatectomy
- Surgical history of colorectal- or liver resection for neoplastic disease
- Surgical history of major or complicated open abdominal surgery
- Indication for concurrent thermal ablation
- Medical history of thermal ablation of liver for malignancy
- Unresectable extrahepatic metastases
- Pre-operatively reconstruction of vessels/bile ducts is deemed necessary
Sites / Locations
- Ziekenhuis Oost-Limburg
- General Hospital GroeningeRecruiting
- Antoine-Béclère Hospital
- Klinikum Saarbrücken, Klinik für Allgemein-, Viszeral- und Thoraxchirurgie, Chirurgische OnkologieRecruiting
- Federico II University Hospital
- Azienda USL di BolognaRecruiting
- Azienda Ospedaliero-Universitaria di Modena
- Parma University Hospital
- Fondazione Policlinico Universitario Agostino Gemelli IRCCSRecruiting
- Fondazione Poliambulanza Istituto OspedalieroRecruiting
- San Raffaele University Hospital
- Ospedali Riuniti
- Mauriziano Umberto I Hospital
- University Hospital PadovaRecruiting
- Centre Hospitalier du LuxembourgRecruiting
- Maastricht University Medical Center
- Amsterdam UMCRecruiting
- Oslo University HospitalRecruiting
- Moscow Clinical Scientific CenterRecruiting
- Hospital del MarRecruiting
- University of Navarrra Hospital (Clinica Universitaria)
- Manchester University NHS Foundation Trust
- Newcastle-upon-Tyne Hospitals NHS Trust
- Liverpool University Hospitals NHS Foundation Trust
- University Hospital Southampton NHS Foundation Trust
- King's College Hospital NHS Trust
- University Hospital Plymouth NHS Trust
- University Hospital Birmingham NHS Foundation Trust
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Minimally invasive two-stage resection
Minimally invasive simultaneous resection
Minimally invasive resection of the primary colorectal carcinoma and liver metastases in two stages. The liver metastases or the colorectal carcinoma can be resected during the first surgical procedure.
Minimally invasive resection of both the primary colorectal carcinoma and the liver metastases in one procedure.