Perioperative chemotherapy versus surgery alone for resectable colorectal liver metastases: an international multicentre propensity score matched analysis on long-term outcomes according to established prognostic risk scores
| Autor: | Juan Carlos Rodríguez Sanjuán, Arancha Prada Villaverde, Roberto Fernández Santiago, Nicholas Syn, Tullio Piardi, Alejandro J. Perez-Alonso, Ye-Xin Koh, Dimitri Dorcaratto, Miguel Ángel Suárez Muñoz, Gerardo Blanco Fernández, Georgina Ferret, María-Carmen Fernández-Moreno, Rami Rhaiem, Elena Martín-Pérez, Robert Jones, Aurélien Dupré, Marcello Di Martino, Santiago López Ben, Ángela de la Hoz Rodríguez, F. Primavesi |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Independent predictor Resection 03 medical and health sciences 0302 clinical medicine Risk Factors Perioperative chemotherapy Long term outcomes medicine Overall survival Hepatectomy Humans Propensity Score Retrospective Studies Hepatology business.industry Liver Neoplasms Gastroenterology Perioperative Prognosis Surgery 030220 oncology & carcinogenesis Propensity score matching 030211 gastroenterology & hepatology Neoplasm Recurrence Local Colorectal Neoplasms business Clinical risk factor |
| Zdroj: | HPB. 23:1873-1885 |
| ISSN: | 1365-182X |
| DOI: | 10.1016/j.hpb.2021.04.026 |
| Popis: | Background There is still uncertainty regarding the role of perioperative chemotherapy (CTx) in patients with resectable colorectal liver metastases (CRLM), especially in those with a low-risk of recurrence. Methods Multicentre retrospective analysis of patients with CRLM undergoing liver resection between 2010–2015. Patients were divided into two groups according to whether they received perioperative CTx or not and were compared using propensity score matching (PSM) analysis. Then, they were stratified according to prognostic risk scores, including: Clinical Risk Score (CRS), Tumour Burden Score (TBS) and Genetic And Morphological Evaluation (GAME) score. Results The study included 967 patients with a median follow-up of 68 months. After PSM analysis, patients with perioperative CTx presented prolonged overall survival (OS) in comparison with the surgery alone group (82.8 vs 52.5 months, p = 0.017). On multivariable analysis perioperative CTx was an independent predictor of increased OS (HR 0.705, 95%CI 0.705–0.516, p = 0.029). The benefits of perioperative CTx on survival were confirmed in patients with CRS and TBS scores ≤2 (p = 0.022 and p = 0.020, respectively) and in patients with a GAME score ≤1 (p = 0.006). Conclusion Perioperative CTx demonstrated an increase in OS in patients with CRLM. Patients with a low-risk of recurrence seem to benefit from systemic treatment. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|