ArticleAnnals of surgical oncology2015
Surgical Referral for Colorectal Liver Metastases: A Population-Based Survey.
Article in Annals of surgical oncology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Outcomes of Hepatic Artery-Based Therapies and Systemic Multiagent Chemotherapy in Unresectable Colorectal Liver Metastases: A Systematic Review and Meta-analysis.Annals of surgical oncology · 2024Pooled it
- Does the Gadoxetic Acid-Enhanced Liver MRI Impact on the Treatment of Patients with Colorectal Cancer? Comparison Study with ¹⁸F-FDG PET/CT.BioMed research international · 2016Trial
- Global Perspectives on Radiotherapy Utilization for Pancreatic Ductal Adenocarcinoma.Journal of gastrointestinal cancer · 2026Article
- Article
- The Geography of Liver Resection: Travel Distance, Facility Volume, and Access to Specialized Care in an Urban Setting.Annals of surgical oncology · 2026Article
- Rurality and Use of Metastasis-Directed Therapies for Medicare Beneficiaries with Metastatic Colon Cancer: A Retrospective Cohort Study.Annals of surgical oncology · 2026Article
- The surgical perspective on CAIRO5 and beyond: all patients with colorectal liver metastases should be evaluated by a liver surgeon, but what defines resectability?Journal of gastrointestinal oncology · 2025Article
- Review
- Colorectal Liver Metastases: Exploring the Extent of Agreement.Annals of surgical oncology · 2023Article
- Article
- Geographic variation in attitudes regarding management of locally advanced pancreatic cancer.Surgery open science · 2022Article
- Hospital factors and metastatic surgery in colorectal cancer patients, a population-based cohort study.BMC cancer · 2022Article
- Surgical Resection of Colorectal Liver Metastases: Attitudes and Practice Patterns in the Deep South.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022Article
- Review
- Failure to Cure Patients with Colorectal Liver Metastases: The Impact of the Liver Surgeon.Annals of surgical oncology · 2021Article
- Proclivity to Explore Locally Advanced Pancreas Cancer Is Not Associated with Surgeon Volume.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- The impact of socioeconomic status on survival in stage III colon cancer patients: A retrospective cohort study using the SEER census-tract dataset.Cancer medicine · 2021Article
- Development and characteristics of a multidisciplinary colorectal cancer clinic.American journal of surgery · 2021Observational
- Addressing the variation in hepatic surgery for colorectal liver metastasis.Hepatobiliary surgery and nutrition · 2021Article
- Systematic failure to operate on colorectal cancer liver metastases in California.Cancer medicine · 2020Article
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Authors and funding
8 authors.
Funding
Abstract
backgroundSurgical resection is underutilized for patients with colorectal liver metastases (CLM). Although the causes of underutilization are poorly understood, provider attitudes towards surgical referral may be contributory. We sought to understand medical oncologists' perspectives on referral for CLM.
methodsMedical oncologists who treat colorectal cancer in the US state of Michigan were surveyed. We characterized respondents' attitudes regarding clinical and tumor-related contraindications to liver resection for CLM, as well as referral and treatment preferences using case-based scenarios. We then evaluated practice characteristics and treatment preferences between physicians.
resultsA total of 112 eligible responses were received (46 % response rate). Nearly 40 % of respondents reported having no liver surgeons in their practice area. Commonly perceived contraindications to liver resection included extrahepatic disease (80.3 %), poor performance status (77.7 %), the presence of >4 metastases (62.5 %), bilobar metastases (43.8 %), and metastasis size >5 cm (40.2 %). Compared with high-referring physicians, low-referring physicians were just as likely to refer a patient with very low recurrence risk (89.3 vs. 98.3 %; p = 0.099), but much less likely to refer a patient with moderate risk (0 vs. 82.8 %; p < 0.001). High-referring physicians were more likely to consider resection for scenarios consistent with higher recurrence risk (31.0 vs. 10.7 %; p = 0.05).
conclusionsWe found wide variation in surgical referral patterns for CLM. Many felt that bilobar disease and tumor size were contraindications to liver-directed therapy despite a lack of supporting data. These findings suggest an urgent need to increase dissemination of evidence and guidance regarding management for CLM, perhaps through increased specialist participation in tumor boards.
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