Sistema de Salut de Catalunya
Institut Català de la Salut
[Innominato PF] Oncology Department, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, Bangor, UK. Cancer Research Centre, Warwick Medical School, University of Warwick, Coventry, UK. UPR “Chronotherapy, Cancers and Transplantation”, Faculty of Medicine, Paris-Saclay University, Villejuif, France. [Cailliez V, Allard MA] AP-HP, Hôpital Paul Brousse, Centre Hépato-Biliaire, Research Unit Chronotherapy, Cancers and Transplantation, University Paris Saclay, Villejuif, France. [Lopez-Ben S] Hospital Josep Trueta, Girona, Spain. [Ferrero A] Ospedale Mauriziano Umberto I, Torino, Italy. [Marques H] Hospital de Curry Cabral, Lisboa, Portugal. [Dopazo C] Vall d’Hebron Hospital Universitari, Barcelona, Spain
Vall d'Hebron Barcelona Hospital Campus
2022-11-11T12:45:09Z
2022-11-11T12:45:09Z
2022-09-05
Liver metastases; Liver resection; Preoperative chemotherapy
Metástasis hepáticas; Resección hepática; Quimioterapia preoperatoria
Metàstasis hepàtiques; Resecció hepàtica; Quimioteràpia preoperatòria
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.
Article
Published version
English
Fetge - Càncer - Cirurgia; Còlon - Càncer - Cirurgia; Avaluació de resultats (Assistència sanitària); ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Digestive System Surgical Procedures::Hepatectomy; DISEASES::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Liver Neoplasms; Other subheadings::Other subheadings::Other subheadings::/surgery; DISEASES::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::procedimientos quirúrgicos del sistema digestivo::hepatectomía; ENFERMEDADES::neoplasias::neoplasias por localización::neoplasias del sistema digestivo::neoplasias hepáticas; Otros calificadores::Otros calificadores::Otros calificadores::/cirugía; ENFERMEDADES::neoplasias::neoplasias por localización::neoplasias del sistema digestivo::neoplasias gastrointestinales::neoplasias intestinales::neoplasias colorrectales
MDPI
Cancers;14(17)
https://doi.org/10.3390/cancers14174340
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
Articles científics - HVH [3440]
