Survival of patients with colorectal liver metastases treated with and without preoperative chemotherapy
| العنوان: | Survival of patients with colorectal liver metastases treated with and without preoperative chemotherapy |
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| المؤلفون: | Michelle.R. de Graaff, Joost M. Klaase, Ronald M. van Dam, Koert F.D. Kuhlmann, Geert Kazemier, Rutger-Jan Swijnenburg, Arthur K.E. Elfrink, Cees Verhoef, J.Sven Mieog, Peter B. van den Boezem, Paul Gobardhan, Arjen M. Rijken, Daan J. Lips, Wouter G.K. Leclerq, Hendrik A. Marsman, Peter van Duijvendijk, Joost A.B. van der Hoeven, Maarten Vermaas, Marcel den Dulk, Dirk J. Grünhagen, Niels F.M. Kok, Carlijn I. Buis, Jeroen Hagendoorn, Wouter J.M. Derksen, Hans Torrenga, Eric Manusama, N. Tjarda van Heek, Steven J. Oosterling, Koop Bosscha, Andries E. Braat, Frederik J.H. Hoogwater, Esther C.J. Consten, Christiaan van der Leij, Mark C. Burgmans, Mike S.L. Liem, Eric J.Th Belt, Gijs A. Patijn |
| المساهمون: | Surgery |
| المصدر: | for Dutch Hepato Biliary Audit Group, Collaborators 2023, ' Survival of patients with colorectal liver metastases treated with and without preoperative chemotherapy : Nationwide propensity score-matched study ', European Journal of Surgical Oncology . https://doi.org/10.1016/j.ejso.2023.05.007Test European Journal of Surgical Oncology. W.B. Saunders |
| سنة النشر: | 2023 |
| مصطلحات موضوعية: | Oncology, Surgery, General Medicine |
| الوصف: | Introduction: Routine treatment with preoperative systemic chemotherapy (CTx) in patients with colorectal liver metastases (CRLM) remains controversial due to lack of consistent evidence demonstrating associated survival benefits. This study aimed to determine the effect of preoperative CTx on overall survival (OS) compared to surgery alone and to assess hospital and oncological network variation in 5-year OS. Methods: This was a population-based study of all patients who underwent liver resection for CRLM between 2014 and 2017 in the Netherlands. After 1:1 propensity score matching (PSM), OS was compared between patients treated with and without preoperative CTx. Hospital and oncological network variation in 5-year OS corrected for case-mix factors was calculated using an observed/expected ratio. Results: Of 2820 patients included, 852 (30.2%) and 1968 (69.8%) patients were treated with preoperative CTx and surgery alone, respectively. After PSM, 537 patients remained in each group, median number of CRLM; 3 [IQR 2–4], median size of CRLM; 28 mm [IQR 18–44], synchronous CLRM (71.1%). Median follow-up was 80.8 months. Five-year OS rates after PSM for patients treated with and without preoperative chemotherapy were 40.2% versus 38.3% (log-rank P = 0.734). After stratification for low, medium, and high tumour burden based on the tumour burden score (TBS) OS was similar for preoperative chemotherapy vs. surgery alone (log-rank P = 0.486, P = 0.914, and P = 0.744, respectively). After correction for non-modifiable patient and tumour characteristics, no relevant hospital or oncological network variation in five-year OS was observed. Conclusion: In patients eligible for surgical resection, preoperative chemotherapy does not provide an overall survival benefit compared to surgery alone. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 0748-7983 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4458b089a2a17dcb5bb0b48e20f1d59bTest http://www.scopus.com/inward/record.url?scp=85161650258&partnerID=8YFLogxKTest |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....4458b089a2a17dcb5bb0b48e20f1d59b |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 07487983 |
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