Treatment strategy for resectable colorectal cancer liver metastases from the viewpoint of time to surgical failure.

Autor: Hirokawa F; Department of General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan. fumitoshi.hirokawa@ompu.ac.jp., Ueno M; Second Department of Surgery, Wakayama Medical University, Wakayama, Japan., Nakai T; Department of Surgery, Faculty of Medicine, Kinki University, Osaka-Sayama, Japan., Kaibori M; Department of Surgery, Hirakata Hospital, Kansai Medical University, Hirakata, Osaka, Japan., Nomi T; Department of Surgery, Nara Medical University, Kashihara, Japan., Iida H; Department of Surgery, Shiga University of Medical Science, Otsu, Japan., Tanaka S; Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan., Komeda K; Department of General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan., Hayami S; Second Department of Surgery, Wakayama Medical University, Wakayama, Japan., Kosaka H; Department of Surgery, Hirakata Hospital, Kansai Medical University, Hirakata, Osaka, Japan., Hokuto D; Department of Surgery, Nara Medical University, Kashihara, Japan., Kubo S; Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan., Uchiyama K; Department of General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan.
Jazyk: angličtina
Zdroj: Langenbeck's archives of surgery [Langenbecks Arch Surg] 2022 Mar; Vol. 407 (2), pp. 699-706. Date of Electronic Publication: 2021 Nov 06.
DOI: 10.1007/s00423-021-02372-w
Abstrakt: Purpose: The efficacy of pre or postoperative chemotherapy for resectable colorectal cancer liver metastases (CRLM) is disputed. This study aimed to examine the risk factors for time to surgical failure (TSF) and analyze the efficacy of pre or postoperative chemotherapy prior to liver resection for CRLM.
Methods: The clinicopathological factors of 567 patients who underwent initial hepatectomy for CRLM at 7 university hospitals between April 2007 and March 2013 were retrospectively analyzed. The prognostic factors were identified and then stratified into two groups according to the number of preoperative prognostic factors: the high-score group (H-group, score 2-4) and the low-score group (L-group, score 0 or 1).
Results: Patients who experienced unresectable recurrence within 12 months after initial treatment had a significantly shorter prognosis than other patients (p < 0.001). Multivariate analysis identified age ≥ 70 (p = 0.001), pT4 (p = 0.015), pN1 (p < 0.001), carbohydrate antigen 19-9 ≥ 37 U/ml (p = 0.002), Clavien-Dindo grade ≥ IIIa (p = 0.013), and postoperative chemotherapy (p = 0.006) as independent prognostic factors. In the H-group, patients who received chemotherapy had a better prognosis than those who did not (p = 0.001).
Conclusion: Postoperative chemotherapy is beneficial in colorectal cancer patients with more than two of the following factors: age ≥ 70, carbohydrate antigen 19-9-positivity, pT4, and lymph node metastasis.
(© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
Externí odkaz: