دورية أكاديمية
Resection of Colorectal Liver Metastases After Second-Line Chemotherapy: Is It Worthwhile? A LiverMetSurvey Analysis of 6415 Patients
| العنوان: | Resection of Colorectal Liver Metastases After Second-Line Chemotherapy: Is It Worthwhile? A LiverMetSurvey Analysis of 6415 Patients |
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| المؤلفون: | Adam, R, Yi, B, Innominato, PF, Barroso, E, Laurent, C, Giuliante, F, Capussotti, L, Lapointe, R, Regimbeau, JM, Lopez-Ben, S, Isoniemi, H, Hubert, C, Lin, JK, Gruenberger, T, Elias, D, Skipenko, OG, Guglielmi, A |
| بيانات النشر: | Elsevier |
| سنة النشر: | 2017 |
| المجموعة: | Repositório do Centro Hospitalar de Lisboa Central EPE |
| مصطلحات موضوعية: | Antibodies, Monoclonal, Antineoplastic Combined Chemotherapy Protocols, Camptothecin, Catheter Ablation, Cetuximab, Disease Progression, Disease-Free Survival, Female, Hepatectomy, Humans, Liver Neoplasms, Lymphatic Metastasis, Male, Middle Aged, Postoperative Care, Preoperative Care, Prospective Studies, Registries, Colonic Neoplasms, Rectal Neoplasms, CHLC CHBPT |
| الوصف: | PURPOSE: Patient outcome after resection of colorectal liver metastases (CLM) following second-line preoperative chemotherapy (PCT) performed for insufficient response or toxicity of the first-line, is little known and has here been compared to the outcome following first-line. PATIENTS AND METHODS: From January 2005 to June 2013, 5624 and 791 consecutive patients of a prospective international cohort received 1 and 2 PCT lines before CLM resection (group 1 and 2, respectively). Survival and prognostic factors were analysed. RESULTS: After a mean follow-up of 30.1 months, there was no difference in survival from CLM diagnosis (median, 3-, and 5-year overall survival [OS]: 58.6 months, 76% and 49% in group 2 versus 58.9 months, 71% and 49% in group 1, respectively, P = 0.32). After hepatectomy, disease-free survival (DFS) was however shorter in group 2: 17.2 months, 27% and 15% versus 19.4 months, 32% and 23%, respectively (P = 0.001). Among the initially unresectable patients of group 1 and 2, no statistical difference in OS or DFS was observed. Independent predictors of worse OS in group 2 were positive primary lymph nodes, extrahepatic disease, tumour progression on second line, R2 resection and number of hepatectomies/year <50. Positive primary nodes, synchronous and bilateral metastases were predictors of shorter DFS. Initial unresectability did not impact OS or DFS in group 2. CONCLUSION: CLM resection following second-line PCT, after oncosurgically favourable selection, could bring similar OS compared to what observed after first-line. For initially unresectable patients, OS or DFS is comparable between first- and second-line PCT. Surgery should not be denied after the failure of first-line chemotherapy. ; info:eu-repo/semantics/publishedVersion |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | Eur J Cancer. 2017 Jun;78:7-15; http://hdl.handle.net/10400.17/2922Test |
| DOI: | 10.1016/j.ejca.2017.03.009 |
| الإتاحة: | https://doi.org/10.1016/j.ejca.2017.03.009Test http://hdl.handle.net/10400.17/2922Test |
| حقوق: | openAccess |
| رقم الانضمام: | edsbas.215D00A3 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.ejca.2017.03.009 |
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