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Impact of preoperative chemotherapy features on patient outcomes after hepatectomy for initially unresectable colorectal cancer liver metastases : a LiverMetSurvey analysis
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(2022) Impact of preoperative chemotherapy features on patient outcomes after hepatectomy for initially unresectable colorectal cancer liver metastases : a LiverMetSurvey analysis. Cancers, 14 (17). 4340. doi:10.3390/cancers14174340
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WRAP-impact-preoperative-chemotherapy-features-patient-outcomes-hepatectomy-initially-unresectable-colorectal-cancer-liver-metastases-Innominato-2022.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (1607Kb) | Preview |
Official URL: https://doi.org/10.3390/cancers14174340
Abstract
Background: Prognostic factors have been extensively reported after resection of colorectal liver metastases (CLM); however, specific analyses of the impact of preoperative systemic anticancer therapy (PO-SACT) features on outcomes is lacking. Methods: For this real-world evidence study, we used prospectively collected data within the international surgical LiverMetSurvey database from all patients with initially-irresectable CLM. The main outcome was Overall Survival (OS) after surgery. Disease-free (DFS) and hepatic-specific relapse-free survival (HS-RFS) were secondary outcomes. PO-SACT features included duration (cumulative number of cycles), choice of the cytotoxic backbone (oxaliplatin- or irinotecan-based), fluoropyrimidine (infusional or oral) and addition or not of targeted monoclonal antibodies (anti-EGFR or anti-VEGF). Results: A total of 2793 patients in the database had received PO-SACT for initially irresectable diseases. Short (<7 or <13 cycles in 1st or 2nd line) PO-SACT duration was independently associated with longer OS (HR: 0.85 p = 0.046), DFS (HR: 0.81; p = 0.016) and HS-RFS (HR: 0.80; p = 0.05). All other PO-SACT features yielded basically comparable results. Conclusions: In this international cohort, provided that PO-SACT allowed conversion to resectability in initially irresectable CLM, surgery performed as soon as technically feasible resulted in the best outcomes. When resection was achieved, our findings indicate that the choice of PO-SACT regimen had a marginal if any, impact on outcomes.
| Item Type: | Journal Article | ||||||
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| Subjects: | R Medicine > RC Internal medicine R Medicine > RD Surgery |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| SWORD Depositor: | Library Publications Router | ||||||
| Library of Congress Subject Headings (LCSH): | Colon (Anatomy) -- Cancer, Rectum -- Cancer, Hepatectomy , Liver -- Surgery, Liver metastasis , Liver -- Cancer, Cancer -- Adjuvant treatment | ||||||
| Journal or Publication Title: | Cancers | ||||||
| Publisher: | MDPI | ||||||
| ISSN: | 2072-6694 | ||||||
| Official Date: | 5 September 2022 | ||||||
| Dates: |
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| Volume: | 14 | ||||||
| Number: | 17 | ||||||
| Article Number: | 4340 | ||||||
| DOI: | 10.3390/cancers14174340 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access |
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