High resection rates of colorectal liver metastases after standardized follow-up and multimodal management: an outcome study within the COLOFOL trial.

Humans Follow-Up Studies Hepatectomy / adverse effects Colorectal Neoplasms / pathology Liver Neoplasms / surgery Outcome Assessment, Health Care Retrospective Studies Neoplasm Recurrence, Local

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:
Jul 2023
Historique:
received: 27 10 2022
revised: 27 01 2023
accepted: 03 03 2023
medline: 19 6 2023
pubmed: 27 3 2023
entrez: 26 3 2023
Statut: ppublish

Résumé

Outcome after colorectal liver metastases (CRLM) resection has improved over time, despite increased resection rates. Hence, it's crucial to identify all patients possible to treat with curative intent. The objectives of this study were to map recurrence pattern, treatment strategy and survival depending on treatment and follow-up strategy. In the COLOFOL-trial, patients with radically resected stage II-III colorectal cancer were randomized to high-frequency (6, 12, 18, 24 and 36 months; HF) or low-frequency (12 and 36 months; LF) follow-up. In this study, all CRLM within 5 years were identified and medical files scrutinized. Overall survival (OS) was analysed in uni- and multivariable analyses. Primary endpoint was 5-year OS. Of 2442 patients, 235 (9.6%) developed metachronous CRLM of which 123 (52.3%) underwent treatment with curative intent, resulting in 5-year OS of 58%. Five-year OS for patients with CRLM was 43% after HF versus 24% after LF. The survival benefit was confirmed for HF 8 years from resection of the primary tumour, HR 0.63 (CI 0.46-0.85). A high proportion of metachronous CRLM was possible to treat with curative intent, yielding high survival rates. More intense follow-up after colorectal cancer resection might be of value in high-risk patients.

Sections du résumé

BACKGROUND BACKGROUND
Outcome after colorectal liver metastases (CRLM) resection has improved over time, despite increased resection rates. Hence, it's crucial to identify all patients possible to treat with curative intent. The objectives of this study were to map recurrence pattern, treatment strategy and survival depending on treatment and follow-up strategy.
METHODS METHODS
In the COLOFOL-trial, patients with radically resected stage II-III colorectal cancer were randomized to high-frequency (6, 12, 18, 24 and 36 months; HF) or low-frequency (12 and 36 months; LF) follow-up. In this study, all CRLM within 5 years were identified and medical files scrutinized. Overall survival (OS) was analysed in uni- and multivariable analyses. Primary endpoint was 5-year OS.
RESULTS RESULTS
Of 2442 patients, 235 (9.6%) developed metachronous CRLM of which 123 (52.3%) underwent treatment with curative intent, resulting in 5-year OS of 58%. Five-year OS for patients with CRLM was 43% after HF versus 24% after LF. The survival benefit was confirmed for HF 8 years from resection of the primary tumour, HR 0.63 (CI 0.46-0.85).
CONCLUSION CONCLUSIONS
A high proportion of metachronous CRLM was possible to treat with curative intent, yielding high survival rates. More intense follow-up after colorectal cancer resection might be of value in high-risk patients.

Identifiants

DOI: 10.1016/j.hpb.2023.03.003 PMID: 36967324
pubmed: 36967324
pii: S1365-182X(23)00075-8
doi: 10.1016/j.hpb.2023.03.003
pii:
doi:

Types de publication

Randomized Controlled Trial Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

766-774

Investigateurs

Peer Wille-Jørgensen (P)
Erzsébet Horváth-Puhó (E)
Søren Laurberg (S)
Lars Påhlman (L)
Andrew Renehan (A)
Kenneth Smedh (K)
Ingvar Syk (I)
Henrik Christensen (H)
Jesper Dan Nielsen (JD)
Per Jess (P)
Allan Gorm Pedersen (AG)
Mogens Rørbæk Madsen (MR)
Per Vadgaard Andersen (PV)
Erling Østergaard (E)
Pernilla Hansdotter Andersson (PH)
Jonas Bengtsson (J)
Mats Bragmark (M)
Pamela Buchwald (P)
Monika Egenvall (M)
Parastau Farahnak (P)
Joakim Folkesson (J)
Michael Goldinger (M)
Rolf Heuman (R)
Kenneth Lindberg (K)
Anna Martling (A)
Pia Näsvall (P)
Johan Ottosson (J)
Birger Sandzén (B)
Carlos Barberousse (C)

Informations de copyright

Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Auteurs

Peter Scherman (P)

Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Surgery, Helsingborg Hospital, Helsingborg, Sweden. Electronic address: peter.scherman@gu.se.

Pernilla Hansdotter (P)

Department of Surgery, Clinical Sciences Malmö, Lund University, Lund, Sweden; Department of Surgery, Skane University Hospital, Malmö, Sweden.

Erik Holmberg (E)

Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Frank Viborg Mortensen (F)

Department of Surgery, Aarhus University Hospital, Aarhus, Denmark.

Sune H Petersen (SH)

Section of Paediatric Haematology and Oncology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.

Magnus Rizell (M)

Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Transplantation, Sahlgrenska University Hospital, Gothenburg, Sweden.

Peter Naredi (P)

Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.

Ingvar Syk (I)

Department of Surgery, Clinical Sciences Malmö, Lund University, Lund, Sweden; Department of Surgery, Skane University Hospital, Malmö, Sweden.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › High resection rates of colorectal liver...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études de suivi › High resection rates of colorectal liver...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie digestive › Hépatectomie › High resection rates of colorectal liver...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladies gastro-intestinales › Maladies intestinales › Maladies du rectum › Tumeurs colorectales › High resection rates of colorectal liver...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladies du foie › Tumeurs du foie › High resection rates of colorectal liver...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › High resection rates of colorectal liver...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › High resection rates of colorectal liver...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Processus néoplasiques › Récidive tumorale locale › High resection rates of colorectal liver...