Tumor progression during preoperative chemotherapy predicts failure to complete 2-stage hepatectomy for colorectal liver metastases: results of an Italian multicenter analysis of 130 patients
| Autor: | Ivo Giovannini, Gennaro Grande, Giorgio Ercolani, Francesca Ratti, Antonio Daniele Pinna, Bruno Federico, Lorenzo Capussotti, Gennaro Nuzzo, Francesco Ardito, Luca Aldrighetti, Felice Giuliante, Alessandro Ferrero |
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| Přispěvatelé: | Giuliante, F, Ardito, F, Ferrero, A, Aldrighetti, L, Ercolani, G, Grande, G, Ratti, F, Giovannini, I, Federico, B, Pinna, Ad, Capussotti, L, Nuzzo, G, Giuliante, Felice, Ardito, Francesco, Ferrero, Alessandro, Aldrighetti, Luca, Ercolani, Giorgio, Grande, Gennaro, Ratti, Francesca, Giovannini, Ivo, Federico, Bruno, Pinna, Antonio D., Capussotti, Lorenzo, Nuzzo, Gennaro |
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_treatment Settore MED/18 - CHIRURGIA GENERALE CRLM Colorectal Neoplasm Gastroenterology Abbreviations and Acronym Antineoplastic Agent Risk Factors Retrospective Studie Recurrence 2-stage hepatectomy Clinical endpoint Treatment Failure Stage (cooking) portal vein embolization Aged 80 and over Liver resection TSH Liver Neoplasms portal vein ligation Middle Aged Primary tumor Combined Modality Therapy Embolization Therapeutic Long term survival Survival Rate Italy Liver Neoplasm future remnant liver Disease Progression Female Colorectal Neoplasms Human Adult medicine.medical_specialty Prognosis prediction Antineoplastic Agents Internal medicine Response to chemotherapy medicine Humans Hepatectomy Risk factor Abbreviations and Acronyms Survival analysis Retrospective Studies Aged business.industry Risk Factor medicine.disease Surgery Feasibility Studie Colorectal liver metastases PVE FRL Tumor progression Concomitant Preoperative chemotherapy colorectal liver metastase Feasibility Studies PVL business |
| Zdroj: | Journal of the American College of Surgeons 219 (2014): 285–294. doi:10.1016/j.jamcollsurg.2014.01.063 info:cnr-pdr/source/autori:Giuliante F.; Ardito F.; Ferrero A.; Aldrighetti L.; Ercolani G.; Grande G.; Ratti F.; Giovannini I.; Federico B.; Pinna A.D.; Capussotti L.; Nuzzo G./titolo:Tumor progression during preoperative chemotherapy predicts failure to complete 2-stage hepatectomy for colorectal liver metastases: Results of an Italian multicenter analysis of 130 patients/doi:10.1016%2Fj.jamcollsurg.2014.01.063/rivista:Journal of the American College of Surgeons/anno:2014/pagina_da:285/pagina_a:294/intervallo_pagine:285–294/volume:219 |
| Popis: | BACKGROUND: We aimed to evaluate the feasibility and long-term results of 2-stage hepatectomy (TSH) in patients with bilobar colorectal liver metastases (CRLM). STUDY DESIGN: We performed a retrospective multicenter study including 4 Italian hepatobiliary surgery units. One hundred thirty patients were selected for TSH between 2002 and 2011. The primary endpoint was feasibility of TSH and analysis of factors associated with failure to complete the procedure. The secondary endpoint was the long-term survival analysis. RESULTS: Patients presented with synchronous CRLM in 80.8% of cases, with a mean number of 8.3 CRLM and with concomitant extrahepatic disease in 20.0% of cases. The rate of failure to complete TSH was 21.5% and tumor progression was the most frequent reason for failure (18.5% of cases). Primary tumor characteristics, type, number, and distribution of CRLM were not associated with significantly different risks of disease progression. Multivariable logistic regression analysis showed that tumor progression during prehepatectomy chemotherapy was the only independent risk factor for failure to complete TSH. The 5- and 10-year overall survival rates for patients who completed TSH were 32.1% and 24.1%, respectively, with a median survival of 43 months. Duration of prehepatectomy chemotherapy >= 6 cycles was found to be the only independent predictor of overall and disease-free survival. CONCLUSIONS: This study showed that selection of patients by response to prehepatectomy chemotherapy may be extremely important before planning TSH because tumor progression while receiving prehepatectomy chemotherapy was associated with significantly higher risk of failure to complete the second stage. For patients who completed the TSH strategy, long-term outcomes can be achieved with results similar to those observed after single-stage hepatectomy. (C) 2014 by the American College of Surgeons. |
| Databáze: | OpenAIRE |
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