Hepatic and Extrahepatic Colorectal Metastases Have Discordant Responses to Systemic Therapy. Pathology Data from Patients Undergoing Simultaneous Resection of Multiple Tumor Sites.

chemotherapy colorectal hepatic and extrahepatic metastases lung metastases lymph node metastases peritoneal metastases response to chemotherapy systemic therapy targeted therapies tumor regression grade

Journal

Cancers
ISSN: 2072-6694
Titre abrégé: Cancers (Basel)
Pays: Switzerland
ID NLM: 101526829

Informations de publication

Date de publication:
26 Jan 2021
Historique:
received: 31 12 2020
revised: 19 01 2021
accepted: 21 01 2021
entrez: 3 2 2021
pubmed: 4 2 2021
medline: 4 2 2021
Statut: epublish

Résumé

Systemic therapy is the standard treatment for patients with hepatic and extrahepatic colorectal metastases. It is assumed to have the same effectiveness on all disease foci, independent of the involved organ. The present study aims to compare the response rates of hepatic and extrahepatic metastases to systemic therapy. All consecutive patients undergoing simultaneous resection of hepatic and extrahepatic metastases from colorectal cancer after oxaliplatin- and/or irinotecan-based preoperative chemotherapy were analyzed. All specimens were reviewed. Pathological response to chemotherapy was classified according to tumor regression grade (TRG). We analyzed 45 patients undergoing resection of 134 hepatic and 72 extrahepatic metastases. Lung and lymph node metastases had lower response rates to chemotherapy than liver metastases (TRG 4-5 95% and 100% vs. 67%, Response to chemotherapy of distant metastases from colorectal cancer varies in different organs. Systemic treatment is highly effective for peritoneal metastases, more so than liver metastases, while it has a very poor impact on lung and lymph node metastases.

Sections du résumé

BACKGROUND BACKGROUND
Systemic therapy is the standard treatment for patients with hepatic and extrahepatic colorectal metastases. It is assumed to have the same effectiveness on all disease foci, independent of the involved organ. The present study aims to compare the response rates of hepatic and extrahepatic metastases to systemic therapy.
METHODS METHODS
All consecutive patients undergoing simultaneous resection of hepatic and extrahepatic metastases from colorectal cancer after oxaliplatin- and/or irinotecan-based preoperative chemotherapy were analyzed. All specimens were reviewed. Pathological response to chemotherapy was classified according to tumor regression grade (TRG).
RESULTS RESULTS
We analyzed 45 patients undergoing resection of 134 hepatic and 72 extrahepatic metastases. Lung and lymph node metastases had lower response rates to chemotherapy than liver metastases (TRG 4-5 95% and 100% vs. 67%,
CONCLUSIONS CONCLUSIONS
Response to chemotherapy of distant metastases from colorectal cancer varies in different organs. Systemic treatment is highly effective for peritoneal metastases, more so than liver metastases, while it has a very poor impact on lung and lymph node metastases.

Identifiants

pubmed: 33530435
pii: cancers13030464
doi: 10.3390/cancers13030464
pmc: PMC7865224
pii:
doi:

Types de publication

Journal Article

Langues

eng

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Auteurs

Luca Vigano (L)

Division of Hepatobiliary and General Surgery-Department of Surgery, Humanitas Clinical and Research Center-IRCCS, 20089 Rozzano, Milan, Italy.
Department of Biomedical Science, Humanitas University, 20090 Pieve Emanuele, Milan, Italy.

Pio Corleone (P)

Division of Hepatobiliary and General Surgery-Department of Surgery, Humanitas Clinical and Research Center-IRCCS, 20089 Rozzano, Milan, Italy.
Department of General Surgery, Cattinara Hospital, University of Trieste, 34149 Trieste, Italy.

Shadya Sara Darwish (SS)

Division of Hepatobiliary and General Surgery-Department of Surgery, Humanitas Clinical and Research Center-IRCCS, 20089 Rozzano, Milan, Italy.

Nicolò Turri (N)

Department of Biomedical Science, Humanitas University, 20090 Pieve Emanuele, Milan, Italy.

Simone Famularo (S)

Division of Hepatobiliary and General Surgery-Department of Surgery, Humanitas Clinical and Research Center-IRCCS, 20089 Rozzano, Milan, Italy.

Lorenzo Viggiani (L)

Department of Biomedical Science, Humanitas University, 20090 Pieve Emanuele, Milan, Italy.

Lorenza Rimassa (L)

Department of Biomedical Science, Humanitas University, 20090 Pieve Emanuele, Milan, Italy.
Medical Oncology and Hematology Unit, Humanitas Clinical and Research Center-IRCCS, 20089 Rozzano, Milan, Italy.

Daniele Del Fabbro (D)

Division of Hepatobiliary and General Surgery-Department of Surgery, Humanitas Clinical and Research Center-IRCCS, 20089 Rozzano, Milan, Italy.

Luca Di Tommaso (L)

Department of Biomedical Science, Humanitas University, 20090 Pieve Emanuele, Milan, Italy.
Department of Pathology, Humanitas Clinical and Research Center-IRCCS, 20089 Rozzano, Milan, Italy.

Guido Torzilli (G)

Division of Hepatobiliary and General Surgery-Department of Surgery, Humanitas Clinical and Research Center-IRCCS, 20089 Rozzano, Milan, Italy.
Department of Biomedical Science, Humanitas University, 20090 Pieve Emanuele, Milan, Italy.

Classifications MeSH