Hepatic and Extrahepatic Colorectal Metastases Have Discordant Responses to Systemic Therapy. Pathology Data from Patients Undergoing Simultaneous Resection of Multiple Tumor Sites
| Autor: | Guido Torzilli, Lorenzo Viggiani, Luca Viganò, Shadya Sara Darwish, Luca Di Tommaso, Lorenza Rimassa, Pio Corleone, Simone Famularo, Nicolò Turri, Daniele Del Fabbro |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Cancer Research
medicine.medical_specialty Colorectal cancer response to chemotherapy medicine.medical_treatment colorectal hepatic and extrahepatic metastases tumor regression grade chemotherapy Gastroenterology lcsh:RC254-282 Article systemic therapy 03 medical and health sciences 0302 clinical medicine Internal medicine Medicine Lymph node Tumor Regression Grade Chemotherapy Lung business.industry Standard treatment lung metastases medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens targeted therapies Oxaliplatin Irinotecan peritoneal metastases medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology business medicine.drug lymph node metastases |
| Zdroj: | Cancers, Vol 13, Iss 464, p 464 (2021) Cancers Volume 13 Issue 3 |
| ISSN: | 2072-6694 |
| Popis: | Background: Systemic therapy is the standard treatment for patients with hepatic and extrahepatic colorectal metastases. It is assumed to have the same effectiveness on all disease foci, independent of the involved organ. The present study aims to compare the response rates of hepatic and extrahepatic metastases to systemic therapy. Methods: All consecutive patients undergoing simultaneous resection of hepatic and extrahepatic metastases from colorectal cancer after oxaliplatin- and/or irinotecan-based preoperative chemotherapy were analyzed. All specimens were reviewed. Pathological response to chemotherapy was classified according to tumor regression grade (TRG). Results: We analyzed 45 patients undergoing resection of 134 hepatic and 72 extrahepatic metastases. Lung and lymph node metastases had lower response rates to chemotherapy than liver metastases (TRG 4&ndash 5 95% and 100% vs. 67%, p = 0.008, and p = 0.006). Peritoneal metastases had a higher pathological response rate than liver metastases (TRG 1&ndash 3 66% vs. 33%, p < 0.001) and non-hepatic non-peritoneal metastases (3%, p < 0.001). Metastases site was an independent predictor of pathological response to systemic therapy. Conclusions: Response to chemotherapy of distant metastases from colorectal cancer varies in different organs. Systemic treatment is highly effective for peritoneal metastases, more so than liver metastases, while it has a very poor impact on lung and lymph node metastases. |
| Databáze: | OpenAIRE |
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