Prognostic impact of additive chemotherapy after curative resection of metachronous colorectal liver metastasis: a single-centre retrospective study.
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols
/ administration & dosage
Camptothecin
/ administration & dosage
Capecitabine
/ administration & dosage
Chemotherapy, Adjuvant
Colonic Neoplasms
/ pathology
Disease-Free Survival
Female
Fluorouracil
/ administration & dosage
Hepatectomy
Humans
Kaplan-Meier Estimate
Leucovorin
/ administration & dosage
Liver Neoplasms
/ drug therapy
Male
Middle Aged
Organoplatinum Compounds
/ administration & dosage
Prognosis
Proportional Hazards Models
Rectal Neoplasms
/ pathology
Retrospective Studies
Risk Factors
Survival Rate
Time Factors
Additive chemotherapy
Colorectal cancer
Colorectal liver metastasis
Hepatobiliary surgery
Metachronous liver metastasis
Surgical oncology
Journal
BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800
Informations de publication
Date de publication:
03 May 2021
03 May 2021
Historique:
received:
01
09
2020
accepted:
21
02
2021
entrez:
4
5
2021
pubmed:
5
5
2021
medline:
11
8
2021
Statut:
epublish
Résumé
A prognostic benefit of additive chemotherapy in patients following resection of metachronous colorectal liver metastases (CRLM) remains controversial. Therefore, the goal of this retrospective study was to investigate the impact of perioperative chemotherapy on disease-free survival (DFS) and overall survival (OS) of patients after curative resection of metachronous CRLM. In a retrospective single-centre study, patients after curative resection of metachronous CRLM were included and analysed for DFS and OS with regard to the administration of additive chemotherapy. The Kaplan-Meier method was applied to compare DFS and OS while Cox regression models were used to identify independent prognostic variables. Thirty-four of 75 patients were treated with additive 5-FU based chemotherapy. OS was significantly prolonged in this patient subgroup (62 vs 57 months; p = 0.032). Additive chemotherapy significantly improved 10-year survival rates (42% vs 0%, p = 0.023), but not 5-year survival (58% vs 42%, p = 0.24). Multivariate analysis identified additive chemotherapy (p = 0.016, HR 0.44, 95% CI 0.23-0.86), more than five CRLM (p = 0.026, HR 2.46, 95% CI 1.16-10.32) and disease recurrence (0.009, HR 2.70, 95% CI 1.29-5.65) as independent risk factors for OS. Additive chemotherapy significantly prolonged OS and 10-year survival in patients after curative resection of metachronous CRLM. Randomized clinical trials are needed in the future to identify optimal chemotherapy regimens for those patients.
Sections du résumé
BACKGROUND
BACKGROUND
A prognostic benefit of additive chemotherapy in patients following resection of metachronous colorectal liver metastases (CRLM) remains controversial. Therefore, the goal of this retrospective study was to investigate the impact of perioperative chemotherapy on disease-free survival (DFS) and overall survival (OS) of patients after curative resection of metachronous CRLM.
METHODS
METHODS
In a retrospective single-centre study, patients after curative resection of metachronous CRLM were included and analysed for DFS and OS with regard to the administration of additive chemotherapy. The Kaplan-Meier method was applied to compare DFS and OS while Cox regression models were used to identify independent prognostic variables.
RESULTS
RESULTS
Thirty-four of 75 patients were treated with additive 5-FU based chemotherapy. OS was significantly prolonged in this patient subgroup (62 vs 57 months; p = 0.032). Additive chemotherapy significantly improved 10-year survival rates (42% vs 0%, p = 0.023), but not 5-year survival (58% vs 42%, p = 0.24). Multivariate analysis identified additive chemotherapy (p = 0.016, HR 0.44, 95% CI 0.23-0.86), more than five CRLM (p = 0.026, HR 2.46, 95% CI 1.16-10.32) and disease recurrence (0.009, HR 2.70, 95% CI 1.29-5.65) as independent risk factors for OS.
CONCLUSION
CONCLUSIONS
Additive chemotherapy significantly prolonged OS and 10-year survival in patients after curative resection of metachronous CRLM. Randomized clinical trials are needed in the future to identify optimal chemotherapy regimens for those patients.
Identifiants
pubmed: 33941104
doi: 10.1186/s12885-021-07941-2
pii: 10.1186/s12885-021-07941-2
pmc: PMC8091534
doi:
Substances chimiques
Organoplatinum Compounds
0
Capecitabine
6804DJ8Z9U
Leucovorin
Q573I9DVLP
Fluorouracil
U3P01618RT
Camptothecin
XT3Z54Z28A
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
490Références
Br J Cancer. 2017 Aug 22;117(5):604-611
pubmed: 28728167
Curr Opin Oncol. 2010 Jul;22(4):364-73
pubmed: 20520544
Ann Oncol. 2018 Jan 1;29(1):44-70
pubmed: 29155929
Gut. 2006 Aug;55 Suppl 3:iii1-8
pubmed: 16835351
Clin Exp Metastasis. 2013 Apr;30(4):457-70
pubmed: 23180209
Br J Surg. 2006 Apr;93(4):465-74
pubmed: 16523446
Expert Rev Gastroenterol Hepatol. 2015 Feb;9(2):245-59
pubmed: 25033964
Ann Surg. 2010 Nov;252(5):774-87
pubmed: 21037433
J Am Coll Surg. 2010 May;210(5):744-52, 752-5
pubmed: 20421043
Oncotarget. 2017 Aug 18;8(45):79927-79934
pubmed: 29108374
Ann Oncol. 2016 Aug;27(8):1386-422
pubmed: 27380959
J Clin Gastroenterol. 2008 Sep;42(8):945-9
pubmed: 18438208
Surgeon. 2015 Apr;13(2):83-90
pubmed: 25257725
Oncologist. 2012;17(10):1225-39
pubmed: 22962059
BJS Open. 2019 May 14;3(5):678-686
pubmed: 31592094
CA Cancer J Clin. 2014 Mar-Apr;64(2):104-17
pubmed: 24639052
Cancer Treat Rev. 2015 Nov;41(9):729-41
pubmed: 26417845
BMC Cancer. 2018 Jan 15;18(1):78
pubmed: 29334918
Oncol Rep. 2012 Jun;27(6):1849-56
pubmed: 22446591
Clin Colorectal Cancer. 2013 Sep;12(3):188-94
pubmed: 23773458
Ann Surg. 1999 Sep;230(3):309-18; discussion 318-21
pubmed: 10493478
Langenbecks Arch Surg. 2014 Dec;399(8):1031-8
pubmed: 25139067
Dig Surg. 2018;35(3):187-195
pubmed: 28848205
Can J Gastroenterol Hepatol. 2018 Jan 17;2018:8547940
pubmed: 29623266
Ann Surg. 2017 Jan;265(1):158-165
pubmed: 28009741
Ann Surg Oncol. 2007 Feb;14(2):786-94
pubmed: 17103254
ESMO Open. 2018 Jun 23;3(4):e000343
pubmed: 30018809
Ann Oncol. 2004;15 Suppl 4:iv103-6
pubmed: 15477291
ISRN Oncol. 2011;2011:763245
pubmed: 22091431
HPB (Oxford). 2016 Jun;18(6):485-93
pubmed: 27317952