Neoadjuvant Chemotherapy Versus Upfront Surgery for Resectable Liver Metastases from Colorectal Cancer: a Multicenter, Propensity Score-Matched Cohort Study

被引：13

作者：

Hirokawa, Fumitoshi ^{[1
]}

Ueno, Masaki ^{[2
]}

Nakai, Takuya ^{[3
]}

Kaibori, Masaki ^{[4
]}

Nomi, Takeo ^{[5
]}

Iida, Hiroya ^{[6
]}

Tanaka, Shogo ^{[7
]}

Komeda, Koji ^{[1
]}

Hayami, Shinya ^{[2
]}

Kosaka, Hisashi ^{[4
]}

Hokuto, Daisuke ^{[5
]}

Kubo, Shoji ^{[7
]}

Uchiyama, Kazuhisa ^{[1
]}

机构：

[1] Osaka Med & Pharmaceut Univ, Dept Gen & Gastroenterol Surg, 2-7 Daigaku Machi, Takatsuki, Osaka 5698686, Japan

[2] Wakayama Med Univ, Second Dept Surg, Wakayama, Japan

[3] Kinki Univ, Fac Med, Dept Surg, Osaka, Japan

[4] Kansai Med Univ, Hirakata Hosp, Dept Surg, Osaka, Japan

[5] Nara Med Univ, Dept Surg, Kashihara, Nara, Japan

[6] Shiga Univ Med Sci, Dept Surg, Otsu, Shiga, Japan

[7] Osaka City Univ, Dept Hepatobiliary Pancreat Surg, Grad Sch Med, Osaka, Japan

来源：

JOURNAL OF GASTROINTESTINAL SURGERY | 2022年 / 26卷 / 04期

基金：

日本学术振兴会;

关键词：

Neoadjuvant chemotherapy; Colorectal cancer; Liver; Metastasis; Hepatectomy; LONG-TERM SURVIVAL; HEPATIC RESECTION; CLASSIFICATION; COMPLICATIONS; OXALIPLATIN; RECURRENCE; CARCINOMA; FOLFOX4;

D O I：

10.1007/s11605-021-05175-y

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background Adjuvant chemotherapy for resectable colorectal liver metastasis (CRLM) is widely used, but its efficacy lacks clear evidence. This retrospective cohort study investigated the effectiveness of neoadjuvant chemotherapy (NAC) compared to upfront surgery for CRLM. Methods Data from patients with resectable CRLM were analyzed. Short-term outcomes and long-term prognosis were analyzed using propensity score matching. CRLM was stratified according to the H-classification (H1 and H2), and the effectiveness of adjuvant chemotherapy was analyzed in each group. Results We analyzed 599 cases that were matched into an NAC group (n = 136) and an upfront surgery group (n = 136). The proportion of synchronous metastases, H2-classification, and postoperative chemotherapy rate did not differ between the groups. Overall survival (OS) after initial treatment was significantly worse in the NAC group than in the upfront surgery group (P = 0.029). The 5-, 7-, and 10-year OS rates for H1 patients were significantly better in the upfront surgery group than in the NAC group (64%, 51%, and 44% vs. 50%, 31%, and 18%, respectively) (P = 0.004). Conclusion Patients with resectable CRLM should undergo upfront surgery, because NAC did not improve OS after initial treatment in these patients.

引用

页码：772 / 781

页数：10

共 28 条

[1]

[Anonymous], 2012, NCCN CLIN PRACTICE G

[2] Resection of nonresectable liver metastases from colorectal cancer after neoadjuvant chemotherapy [J].

Bismuth, H ;

Adam, R ;

Levi, F ;

Farabos, C ;

Waechter, F ;

Castaing, D ;

Majno, P ;

Engerran, L .

ANNALS OF SURGERY, 1996, 224 (04) :509-520

[3] Neo-adjuvant Chemotherapy-Induced Neutropenia Is Associated with Histological Responses and Outcomes after the Resection of Colorectal Liver Metastases [J].

Chen, Qichen ;

Wu, Chaorui ;

Zhao, Hong ;

Wu, Jianxiong ;

Zhao, Jianjun ;

Bi, Xinyu ;

Li, Zhiyu ;

Huang, Zhen ;

Zhang, Yefan ;

Zhou, Jianguo ;

Cai, Jianqiang .

JOURNAL OF GASTROINTESTINAL SURGERY, 2020, 24 (03) :659-670

[4] Effect of Hospital Volume With Respect to Performing Gastric Cancer Resection on Recurrence and Survival Results From the CRITICS Trial [J].

Claassen, Yvette H. M. ;

van Amelsfoort, Romy M. ;

Hartgrink, Henk H. ;

Dikken, Johan L. ;

de Steur, Wobbe O. ;

van Sandick, Johanna W. ;

van Grieken, Nicole C. T. ;

Cats, Annemieke ;

Boot, Henk ;

Trip, Anouk K. ;

Jansen, Edwin P. M. ;

Kranenbarg, Elma Meershoek-Klein ;

Braak, Jeffrey P. B. M. ;

Putter, Hein ;

Henegouwen, Mark I. van Berge ;

Verheij, Marcel ;

van de Velde, Cornelis J. H. .

ANNALS OF SURGERY, 2019, 270 (06) :1096-1102

[5] Repeat Curative Intent Liver Surgery is Safe and Effective for Recurrent Colorectal Liver Metastasis: Results from an International Multi-institutional Analysis [J].

de Jong, Mechteld C. ;

Mayo, Skye C. ;

Pulitano, Carlo ;

Lanella, Serena ;

Ribero, Dario ;

Strub, Jennifer ;

Hubert, Catherine ;

Gigot, Jean-Francois ;

Schulick, Richard D. ;

Choti, Michael A. ;

Aldrighetti, Luca ;

Mentha, Gilles ;

Capussotti, Lorenzo ;

Pawlik, Timothy M. .

JOURNAL OF GASTROINTESTINAL SURGERY, 2009, 13 (12) :2141-2150

[6] Classification of surgical complications - A new proposal with evaluation in a cohort of 6336 patients and results of a survey [J].

Dindo, D ;

Demartines, N ;

Clavien, PA .

ANNALS OF SURGERY, 2004, 240 (02) :205-213

[7] Survival of patients with initially unresectable colorectal liver metastases treated with FOLFOX/cetuximab or FOLFIRI/cetuximab in a multidisciplinary concept (CELIM study) [J].

Folprecht, G. ;

Gruenberger, T. ;

Bechstein, W. ;

Raab, H. -R. ;

Weitz, J. ;

Lordick, F. ;

Hartmann, J. T. ;

Stoehlmacher-Williams, J. ;

Lang, H. ;

Trarbach, T. ;

Liersch, T. ;

Ockert, D. ;

Jaeger, D. ;

Steger, U. ;

Suedhoff, T. ;

Rentsch, A. ;

Koehne, C. -H. .

ANNALS OF ONCOLOGY, 2014, 25 (05) :1018-1025

[8] Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer - Analysis of 1001 consecutive cases [J].

Fong, Y ;

Fortner, J ;

Sun, RL ;

Brennan, MF ;

Blumgart, LH .

ANNALS OF SURGERY, 1999, 230 (03) :309-318

[9] Bevacizumab, capecitabine, and oxaliplatin as neoadjuvant therapy for patients with potentially curable metastatic colorectal cancer [J].

Gruenberger, Brigit ;

Tamandl, Dietmar ;

Schueller, Johannes ;

Scheithauer, Werner ;

Zielinski, Christoph ;

Herbst, Friedrich ;

Gruenberger, Thomas .

JOURNAL OF CLINICAL ONCOLOGY, 2008, 26 (11) :1830-1835

[10] Is neoadjuvant chemotherapy appropriate for patients with resectable liver metastases from colorectal cancer? [J].

Hirokawa, Fumitoshi ;

Asakuma, Mitsuhiro ;

Komeda, Koji ;

Shimizu, Tetsunosuke ;

Inoue, Yoshihiro ;

Kagota, Syuji ;

Tomioka, Atsushi ;

Uchiyama, Kazuhisa .

SURGERY TODAY, 2019, 49 (01) :82-89

← 1 2 3 →