The impact of hepatic arterial infusion pump chemotherapy on hepatic recurrences and survival in patients with resected colorectal liver metastases.
Journal
HPB : the official journal of the International Hepato Pancreato Biliary Association
ISSN: 1477-2574
Titre abrégé: HPB (Oxford)
Pays: England
ID NLM: 100900921
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
20
06
2019
revised:
11
11
2019
accepted:
24
11
2019
pubmed:
1
1
2020
medline:
26
10
2021
entrez:
1
1
2020
Statut:
ppublish
Résumé
The objective was to investigate the impact of adjuvant hepatic arterial infusion pump (HAIP) chemotherapy on the rates and patterns of recurrence and survival in patients with resected colorectal liver metastases (CRLM). Recurrence rates, patterns, and survival were compared between patients treated with and without adjuvant HAIP using competing risk analyses. 2128 patients were included, of which 601 patients (28.2%) received adjuvant HAIP and systemic chemotherapy (HAIP + SYS). The overall recurrence rate was similar with HAIP + SYS or SYS (63.5% versus 64.2%,p = 0.74). The 5-year cumulative incidence of initial intrahepatic recurrences was lower with HAIP + SYS (22.9% versus 38.4%,p < 0.001). The 5-year cumulative incidence of initial extrahepatic recurrences was higher with HAIP + SYS (48.5% versus 40.3%,p = 0.005), because patients remained at risk for extrahepatic recurrence in the absence of intrahepatic recurrence, which was largely attributable to more pulmonary recurrences with HAIP + SYS (33.6% versus 23.7%,p < 0.001). HAIP was an independent prognostic factor for DFS (adjusted HR 0.69, 95% CI 0.60-0.79, p < 0.001), and OS (adjusted HR 0.67, 95% CI 0.57-0.78,p < 0.001). Adjuvant HAIP chemotherapy is associated with lower intrahepatic recurrence rates and better DFS and OS after resection of CRLM.
Sections du résumé
BACKGROUND
The objective was to investigate the impact of adjuvant hepatic arterial infusion pump (HAIP) chemotherapy on the rates and patterns of recurrence and survival in patients with resected colorectal liver metastases (CRLM).
METHODS
Recurrence rates, patterns, and survival were compared between patients treated with and without adjuvant HAIP using competing risk analyses.
RESULTS
2128 patients were included, of which 601 patients (28.2%) received adjuvant HAIP and systemic chemotherapy (HAIP + SYS). The overall recurrence rate was similar with HAIP + SYS or SYS (63.5% versus 64.2%,p = 0.74). The 5-year cumulative incidence of initial intrahepatic recurrences was lower with HAIP + SYS (22.9% versus 38.4%,p < 0.001). The 5-year cumulative incidence of initial extrahepatic recurrences was higher with HAIP + SYS (48.5% versus 40.3%,p = 0.005), because patients remained at risk for extrahepatic recurrence in the absence of intrahepatic recurrence, which was largely attributable to more pulmonary recurrences with HAIP + SYS (33.6% versus 23.7%,p < 0.001). HAIP was an independent prognostic factor for DFS (adjusted HR 0.69, 95% CI 0.60-0.79, p < 0.001), and OS (adjusted HR 0.67, 95% CI 0.57-0.78,p < 0.001).
CONCLUSION
Adjuvant HAIP chemotherapy is associated with lower intrahepatic recurrence rates and better DFS and OS after resection of CRLM.
Identifiants
pubmed: 31889627
pii: S1365-182X(19)33212-5
doi: 10.1016/j.hpb.2019.11.013
pmc: PMC7890567
mid: NIHMS1668072
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1271-1279Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Informations de copyright
Copyright © 2019 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.
Références
Lancet Oncol. 2013 Nov;14(12):1208-15
pubmed: 24120480
J Clin Oncol. 2007 Oct 10;25(29):4575-80
pubmed: 17925551
Ann Surg. 2020 Aug;272(2):352-356
pubmed: 32675549
Sci Transl Med. 2016 Jul 6;8(346):346ra92
pubmed: 27384348
BMC Cancer. 2019 Apr 5;19(1):327
pubmed: 30953467
Ann Surg. 1999 Sep;230(3):309-18; discussion 318-21
pubmed: 10493478
J Surg Oncol. 2016 Apr;113(5):477-84
pubmed: 26830685
Ann Surg. 2012 Mar;255(3):534-9
pubmed: 22314329
N Engl J Med. 2005 Feb 17;352(7):734-5
pubmed: 15716576
N Engl J Med. 1999 Dec 30;341(27):2039-48
pubmed: 10615075
Ann Surg. 2006 Aug;244(2):254-9
pubmed: 16858188
J Am Coll Surg. 2015 Apr;220(4):471-9
pubmed: 25667141
Surg Oncol Clin N Am. 2008 Oct;17(4):759-71, viii
pubmed: 18722916
BMC Cancer. 2014 Mar 11;14:174
pubmed: 24612620
Semin Oncol. 1983 Jun;10(2):176-82
pubmed: 6346495
Ann Surg Oncol. 2019 Dec;26(13):4599-4607
pubmed: 31641947
BMC Cancer. 2015 Mar 26;15:180
pubmed: 25884448
Am J Pathol. 1954 Sep-Oct;30(5):969-77
pubmed: 13197542
J Am Coll Surg. 2005 Jul;201(1):57-65
pubmed: 15978444
Br J Cancer. 2017 Nov 7;117(10):1427-1441
pubmed: 28982110
Surgery. 1974 Apr;75(4):589-96
pubmed: 4840805
J Clin Oncol. 2017 Jun 10;35(17):1938-1944
pubmed: 28426374
Ann Surg. 2002 Oct;236(4):397-406; discussion 406-7
pubmed: 12368667
Ann Surg Oncol. 2019 Jun;26(6):1824-1832
pubmed: 30706231