2-stage liver resection -- boo. update at end

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skypup
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2-stage liver resection -- boo. update at end

Postby skypup » Mon Apr 21, 2014 9:56 am

Well, I never thought this might be an option for me, but my liver mets have shrunk enough that one aggressive liver surgeon seems willing to take me on even with LN mets (because they are relatively indolent). I don't know for sure yet, but I get to go to MDA to talk with the surgeon Wednesday.

So am looking for info from those of you who have had the two-stage liver surgery. Difficulty relative to abdominal surgery? Recoup time? Days in hospital? Liver regrowth? Chemo between surgeries? Anything else? Thanks in advance!
Last edited by skypup on Wed Apr 23, 2014 1:22 pm, edited 1 time in total.

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singingholly
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Location: Northern Italy

Re: 2-stage liver resection -- info please

Postby singingholly » Mon Apr 21, 2014 10:44 am

Oh dear! These are terrific news! I love aggressive surgeons, and science more and more is confirming they are right!
I went through two liver resection, not properly a two-time resection.
The first time I had five mets taken. I was shocked at that time for my upgrade to stage IV and mental attitude is very important in ricovering... I also had some complication after surgery (nothing important anyway) and so I stayed in the hospital for ten days, then one month for bein totally free from pain (bareble from the beginning anyway) and two months in all to be perfectly normal. I did chemo after surgery and this interfered with the healing of the scar and I had a... I don't know the english word for... laparocele.
Then one invisivle left met became visible and so back again to the surgeon some six months later. This time I was mentally stronger, I just wanted to finish asap and eat a good pizza, so in just five days I could leave the hospital! The time for full recover is two months anyway. My liver regrowth took four months I think... No consequences of any kind for metabosism or abdomen...
May I ask you which kind of node involvement you have and what therapies are you having for this?
Best whishes for everything!
Holly
Dec2011 sigm IIIst res T3N1(2/18)M0 Xelox
Oct2012 5liv.mets Dec 2012 liv.res
Jan2013 1liv.met Folfiri+avastin
Jul2013 liv.res Folfiri+/av
Feb2014 10+2lu.mets & 1abd node Folfoxiri+SBRT
Sep2014 Res rx l. BUT spot on diaph:SBRT
Dec2014 3+6lu.mets.Immuno

skypup
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Re: 2-stage liver resection -- info please

Postby skypup » Mon Apr 21, 2014 11:44 am

singingholly wrote:May I ask you which kind of node involvement you have and what therapies are you having for this?

Thanks for your info about your liver surgeries, Holly.
I have mets in many chains of lymph nodes. It started with paraaortic nodes, and a dissection was done (open surgery) with curative intent, but no luck. The cancer spread to retroperitoneal, mesenteric, more I can't remember, chains but it just kind of goes from one place to another without being very aggressive. Weird. Of course, the shit hit the fan when it found a home in my liver. It's not going to stay in LNs forever, I guess, but it does seem that most of us with LN-only mets had a decent amount of time before things got dicey. I don't think LN mets have been studied much; at least none of the many oncs I have talked to seem to know much about them.

pukalania
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Location: Honolulu, Seattle

Re: 2-stage liver resection -- info please

Postby pukalania » Mon Apr 21, 2014 12:11 pm

Skypup those are great news! My DH had colon/liver resection and recovery was quick...he had a 10h surgery but he walked the halls the next day and was out of the hospital in 5 days. Back to work within 3 weeks. Recovery seemed easier than expected...he started xeloda/celebrex regimen two weeks after surgery.
Good luck so happy you are getting there!
wife 34 dx DH stage IV
Feb10 col res
May10 12 x FOLFOX
Aug12 tumor in sig colon,mets in liver
Aug12 Xeliri Ava
Oct12 xel celebrx rad
Feb13 liver/colon res
Sep13 ill reversal, fistula,
Folfiri SBRT,ADAPT ava
Apr 15 continued growth liver and lungs

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singingholly
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Re: 2-stage liver resection -- info please

Postby singingholly » Mon Apr 21, 2014 12:14 pm

Thank you for information. I found one pancreatic LN that ruined my plans with lung surgery... Now I'm back on chemo and scheduled SBRT on the node, then in a couple of months we will reconsider lung surgery. But I'm on my third line therapy and I'm afraid it won't work that much, so I fear that that one LN will be the first of many... What do you mean when you say that disease moves from place to place? Some nodes heal and others get ill?
Dec2011 sigm IIIst res T3N1(2/18)M0 Xelox
Oct2012 5liv.mets Dec 2012 liv.res
Jan2013 1liv.met Folfiri+avastin
Jul2013 liv.res Folfiri+/av
Feb2014 10+2lu.mets & 1abd node Folfoxiri+SBRT
Sep2014 Res rx l. BUT spot on diaph:SBRT
Dec2014 3+6lu.mets.Immuno

LKGower
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Re: 2-stage liver resection -- info please

Postby LKGower » Mon Apr 21, 2014 12:38 pm

Hi Skypup,

I haven't had a 2-stage liver resection but I just wanted to say what wonderful news it is that you have shared with us! :)

Lisa
Dx 10/12 @ age 28 Stg. IV CRC spread to both ovaries, bladder and liver
Surgery 11/12 - 8/16 LN positive
9/13 Liver resection & RFA - 1/1 LN positive
10/13 boo its back already! Back to chemo

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juliej
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Re: 2-stage liver resection -- info please

Postby juliej » Mon Apr 21, 2014 12:58 pm

Skypup wrote:Well, I never thought this might be an option for me, but my liver mets have shrunk enough that one aggressive liver surgeon seems willing to take me on even with LN mets (because they are relatively indolent). I don't know for sure yet, but I get to go to MDA to talk with the surgeon Wednesday.

Really great news, Skypup! I'm so excited for you! Hooray for indolent, lazy LN mets! :D

I didn't have a 2-stage liver resection, but I had two major surgeries relatively close together (3 months apart). The first surgery included a liver resection and apart from craving every orange vegetable ever created (pumpkin, sweet potatoes, etc.), I recovered relatively quickly. I started back on chemo 3 weeks after surgery and stayed on it until 2 weeks before my next (lung) surgery. It didn't seem to take me any longer to heal because of the chemo, but I did have trouble gaining back the weight I lost. Generally speaking, liver mets are more dangerous/aggressive than your LN mets so getting them taken care of seems like a smart move!
Stage IVb, liver/lung mets 8/4/2010
Xelox+Avastin 8/18/10 to 10/21/2011
LAR, liver resec, HAI pump 11/2011
Adjuvant Irinotecan + FUDR
Double lung surgery + ileo reversal 2/2012
Adjuvant FUDR + Xeloda
VATS rt. lung 12/2012 - benign granuloma!
VATS left lung 11/2013
NED 11/22/13 to 12/18/2019, CEA<1

Badass
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Re: 2-stage liver resection -- info please

Postby Badass » Mon Apr 21, 2014 1:06 pm

Fantastic news!!!! So happy for you! :D :D :D :D :D

Jane
R.C. 12/23/11 at age 52 T3N0M0
3/1/12 completed Xeloda and radiation
5/4/12 LAR & Ileostomy
6/7/12-10/4/12 6 rounds Xelox
11/27/12 Reversal
7/13/13 1 liver met
8/13 Met resection /hai pump
4/14 Chemo completed (Irinotecan/5fu/fudr in pump)

dianne052506
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Location: North Carolina

Re: 2-stage liver resection -- info please

Postby dianne052506 » Mon Apr 21, 2014 1:07 pm

Skypup,
What wonderful news! Do you know yet who the surgeon is? I only had single-stage liver resection, but had Dr. Abdalla at MDA. Absolutely loved him. Perfect blend of compassion and cockiness for a surgeon!
Will be thinking about you on Wednesday,
Dianne
May 06 Stage IV CC: liver,ovarian mets
Oct 07 inoperable lung mets
Feb 08 - Apr'12 chemo
allergic to oxaliplatin, irinotecan
Aug '12-Feb'14 Genentech PD-L1/Avastin trial
Mar '14 -radiation to largest lung nodule
still recovering; looking at trials again

orcasres
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Location: Orcas Island, WA

Re: 2-stage liver resection -- info please

Postby orcasres » Mon Apr 21, 2014 1:12 pm

Skypup,

No advice to offer, just extremely happy for you to have this opportunity. Good luck on Wednesday. Lois
63 yo F
Colon resection Sept. 2010
pT3N0M0 Stage 2A
Medullary Tumor 6.5cm long
Lymphovascular invasion
Lynch negative
12 FOLFOX 11/2010 to 5/2011 8 w/Oxi
NED so far

skypup
Posts: 2598
Joined: Mon Dec 17, 2012 12:12 pm

Re: 2-stage liver resection -- info please

Postby skypup » Mon Apr 21, 2014 1:31 pm

Thanks, everyone, for the good wishes. You make my heart sing!

Dianne, my surgeon-to-be (hopefully!) is Dr Jean Vauthey. I hit the lottery with him, it seems, he is a world leader in this two-stage liver surgery thing. Fingers are so crossed, though, that he will actually take this on and we can get it approved!

Holly, the LN mets never heal. Mine just get to a certain size and seem to stay there, but they spread to other chains of nodes and so over time I just have more and more LN mets. I really don't know why they work this way; like I mentioned, of five or so oncologists I've talked to, none professes any real familiarity with LN mets. They are much more comfortable talking about common old liver mets...

sdp
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Facebook Username: Shitul patel
Location: Mumbai , India

Re: 2-stage liver resection -- info please

Postby sdp » Mon Apr 21, 2014 2:44 pm

Dear sky pup,

Depending on the mets and size you can probably ask the dr if he can do an ALPPS surgery

This will reduce the time between two surgeries and time you are off the chmo so as to reduce the chances of any further. Spread .

I had one major liver resection as the surgeon felt that due to adequate live remnant he could do it in one go - this was in germany of course. - more aggressive - I was In hospital for 15 days due to some infection of the incision and some fluid build up. And the recovery took a bit longer - almost a month thereafter to be at 60 percent of earlier self - bu5 by then could manage most of he usual things one needs to get along with life. No heavy lifting of course and no marathons !

The second liver resection was due to recurrence and I am in hospital recovering from it - bit a very speedy recovery so far ! Unlike the first time.
Dx sig CC/ liver mets stg4 dec/11
10 cyc FOLFOX+Erb
Resect CC And Liver July-Aug/12
2 cyc - FOLFOX+Erb
Erb only -Nov/12-mar/13
iRE to 2 liver met Oct 13
2nd recur Mar 14
Liver resect April '14
3rd recur -july '14
Microwave ablation-2 liver met- July '14

skypup
Posts: 2598
Joined: Mon Dec 17, 2012 12:12 pm

Re: 2-stage liver resection -- info please

Postby skypup » Mon Apr 21, 2014 4:23 pm

Dear sdp,

I don't think we have ALPPS here in the USA. But my potential surgeon is Swiss-trained and I bet he keeps up with what's going on in Europe, where they seem to do a better job at pushing the surgical envelope.

I wish you a speedy, uncomplicated recovery and 100% success!

Thank you for your info.

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CRguy
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Re: 2-stage liver resection -- info please

Postby CRguy » Mon Apr 21, 2014 4:33 pm

Maybe check out this site and registry page for ALPPS info and leads ???????

http://www.alpps.net/?q=registry
http://www.alpps.net/?q=about

Cheers
CRguy

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Maia
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Re: 2-stage liver resection -- info please

Postby Maia » Mon Apr 21, 2014 8:41 pm

I'm sooooo happy for you, Skypuppy!!! :D
Ok, about ALPPS... it happens we have down here (Buenos Aires, Argentina) 3 centers where they do it. It was pioneered by Argie Dr Eduardo de Santibañes (as spd knows it).
You do have ALPPS in USA, Skypup, if required, and certainly your Dr Vauthey is updated about it ( http://www.journalacs.org/article/S1072 ... 3/abstract ) , so just keep calm and carry on : )


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