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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.97 No.5
- 발행연도
- 2019.11
- 수록면
- 245 - 253 (9page)
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초록· 키워드
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Purpose: Current neoadjuvant chemotherapy (NAC) may enable therapies such as surgical resection and local ablation of metastases in patients with colorectal liver metastasis (CLM). We evaluated outcomes in CLM patients who underwent resection and/or local treatment after NAC and identified prognostic factors for oncologic outcomes.
Methods: Patients who received NAC followed by resection and/or local treatment of hepatic metastasis from 2013 to 2015 were included. Treatment and tumor-related variables were tabulated. Recurrence-free survival (RFS) and overall survival (OS) were analyzed using the Kaplan-Meier method. Cox regression analysis was used to identify factors associated with RFS and OS.
Results: Sixty-eight patients received NAC followed by resection and/or local treatment of hepatic metastases. Targeted therapy was administered in 50% of the patients. RFS was 35.8% at 1 year and 19.4% at 2 years postoperatively. OS was 95.6% at 1 year and 88.2% at 2 years postoperatively. In the multivariable analysis, R1 resection margin (hazard ratio [HR], 3.95; P = 0.008) of the liver metastases and ypN1/ypN2 (HR, 2.356 and 1.983, respectively; P = 0.041) were associated with poor RFS. Both factors were also significantly related to OS.
Conclusion: Resection margin of the metastatic tumor and ypN status are the only relevant factors for RFS and OS in CLM patients treated with NAC. Despite early and high rates of recurrence, CLM patients treated with NAC who undergo resection and/or local treatment have acceptable OS. Multidisciplinary review of candidates for surgery and cautious planning are crucial for achieving optimal outcomes.
Methods: Patients who received NAC followed by resection and/or local treatment of hepatic metastasis from 2013 to 2015 were included. Treatment and tumor-related variables were tabulated. Recurrence-free survival (RFS) and overall survival (OS) were analyzed using the Kaplan-Meier method. Cox regression analysis was used to identify factors associated with RFS and OS.
Results: Sixty-eight patients received NAC followed by resection and/or local treatment of hepatic metastases. Targeted therapy was administered in 50% of the patients. RFS was 35.8% at 1 year and 19.4% at 2 years postoperatively. OS was 95.6% at 1 year and 88.2% at 2 years postoperatively. In the multivariable analysis, R1 resection margin (hazard ratio [HR], 3.95; P = 0.008) of the liver metastases and ypN1/ypN2 (HR, 2.356 and 1.983, respectively; P = 0.041) were associated with poor RFS. Both factors were also significantly related to OS.
Conclusion: Resection margin of the metastatic tumor and ypN status are the only relevant factors for RFS and OS in CLM patients treated with NAC. Despite early and high rates of recurrence, CLM patients treated with NAC who undergo resection and/or local treatment have acceptable OS. Multidisciplinary review of candidates for surgery and cautious planning are crucial for achieving optimal outcomes.
목차
METHODS
INTRODUCTION
RESULTS
DISCUSSION
REFERENCES
참고문헌 (30)
참고문헌 신청
Bengtsson G / 1981 / Natural history of patients with untreated liver metastases from colorectal cancer / Am J Surg 141:586~589
Nordlinger B / 1996 / Surgical resection of colorectal carcinoma metastases to the liver. A prognostic scoring system to improve case selection, based on 1568 patients. Association Française de Chirurgie / Cancer 77:1254~1262
Bismuth H / 1996 / Resection of nonresectable liver metastases from colorectal cancer after neoadjuvant chemotherapy / Ann Surg 224:509~520
Hallet J / 2016 / Factors influencing recurrence following initial hepatectomy for colorectal liver metastases / Br J Surg 103:1366~1376
Al len PJ / 2003 / Importance of response to neoadjuvant chemotherapy in patients undergoing resection of synchronous colorectal liver metastases / J Gastrointest Surg 7:109~117
Nordlinger B / 1996 / Surgical resection of colorectal carcinoma metastases to the liver. A prognostic scoring system to improve case selection, based on 1568 patients. Association Française de Chirurgie / Cancer 77:1254~1262
Bismuth H / 1996 / Resection of nonresectable liver metastases from colorectal cancer after neoadjuvant chemotherapy / Ann Surg 224:509~520
Hallet J / 2016 / Factors influencing recurrence following initial hepatectomy for colorectal liver metastases / Br J Surg 103:1366~1376
Al len PJ / 2003 / Importance of response to neoadjuvant chemotherapy in patients undergoing resection of synchronous colorectal liver metastases / J Gastrointest Surg 7:109~117
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UCI(KEPA) : I410-ECN-0101-2019-514-001293896