Importance of histological tumor response assessment in predicting the outcome in patients with colorectal liver metastases treated with neo-adjuvant chemotherapy followed by liver surgery

被引:421
作者
Rubbia-Brandt, L.
Giostra, E.
Brezault, C.
Roth, A. D.
Andres, A.
Audard, V.
Sartoretti, P.
Dousset, B.
Majno, P. E.
Soubrane, O.
Chaussade, S.
Mentha, G.
Terris, B.
机构
[1] Univ Paris 05, Hop Cochin, Div Pathol, F-75679 Paris 14, France
[2] Univ Hosp, Unit Gastrointestinal & Liver Pathol, Geneva, Switzerland
[3] Univ Hosp, Div Visceral & Transplantat Surg, Geneva, Switzerland
[4] Hop Cochin, Div Gastroenterol, F-75674 Paris, France
[5] Univ Hosp, Unit Oncosurg, Geneva, Switzerland
[6] Univ Hosp, Div Clin Pathol, Geneva, Switzerland
[7] Hop Cochin, Div Surg, F-75674 Paris, France
关键词
colorectal cancer; irinotecan; oxaliplatin; pathological response to chemotherapy; sinusoidal obstruction syndrome; tumor regression grade;
D O I
10.1093/annonc/mdl386
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: The purpose of the study was to characterize histological response to chemotherapy of hepatic colorectal metastases (HCRM), evaluate efficacy of different chemotherapies on histological response, and determine whether tumor regression grading (TRG) of HCRM predicts clinical outcome. Patients and methods: TRG was evaluated on 525 HCRM surgically resected from 181 patients, 112 pretreated with chemotherapy. Disease-free survival (DFS) and overall survival (OS) were correlated to TRG. Results: Tumor regression was characterized by fibrosis overgrowing on tumor cells, decreased necrosis, and tumor glands (if present) at the periphery of HCRM. With irinotecan/5-fluorouracil (5-FU), major (MjHR), partial (PHR), and no (NHR) histological tumor regression were observed in 17%, 13%, and 70% of patients, respectively. With oxaliplatin/5-FU, MjHR, PHR, and NHR were observed in 37%, 45%, and 18% of patients, respectively. Five patients, treated with oxaliplatin, had complete response in all their metastases. MjHR was associated with an improved 3-year DFS compared with PHR or NHR. MjHR and PHR were associated with an improved 5-year OS compared with NHR. Conclusion: Histological tumor regression of HCRM to chemotherapy corresponds to fibrosis overgrowth and not to increase of necrosis. TRG should be considered when evaluating efficacy of chemotherapy for HCRM. Histological tumor regression was most common among oxaliplatin-treated patients and associated with better clinical outcome.
引用
收藏
页码:299 / 304
页数:6
相关论文
共 29 条
[1]   Tumor progression while on chemotherapy - A contraindication to liver resection for multiple colorectal metastases? [J].
Adam, R ;
Pascal, G ;
Castaing, D ;
Azoulay, D ;
Delvart, V ;
Paule, B ;
Levi, F ;
Bismuth, H .
ANNALS OF SURGERY, 2004, 240 (06) :1052-1064
[2]  
Adam R, 2004, ANN SURG, V240, P644, DOI 10.1097/01.sla.0000141198.92114.16
[3]   Multi-institutional trial of preoperative chemoradiotherapy in patients with potentially resectable gastric carcinoma [J].
Ajani, JA ;
Mansfield, PF ;
Janjan, N ;
Morris, J ;
Pisters, PW ;
Lynch, PM ;
Feig, B ;
Myerson, R ;
Nivers, R ;
Cohen, DS ;
Gunderson, LL .
JOURNAL OF CLINICAL ONCOLOGY, 2004, 22 (14) :2774-2780
[4]   Oxaliplatin, fluorouracil, and leucovorin for patients with unresectable liver-only metastases from colorectal cancer: A North Central Cancer Treatment Group Phase II study [J].
Alberts, SR ;
Horvath, WL ;
Stcrnfeld, WC ;
Goldberg, RM ;
Mahoney, MR ;
Dakhil, SR ;
Levitt, R ;
Rowland, K ;
Nair, S ;
Sargent, DJ ;
Donohue, JH .
JOURNAL OF CLINICAL ONCOLOGY, 2005, 23 (36) :9243-9249
[5]   Complete response of colorectal liver metastases after chemotherapy:: Does it mean cure? [J].
Benoist, Stephane ;
Brouquet, Antoine ;
Penna, Christophe ;
Julie, Catherine ;
El Hajjam, Mostafa ;
Chagnon, Sophie ;
Mitry, Emmanuel ;
Rougier, Philippe ;
Nordlinger, Bernard .
JOURNAL OF CLINICAL ONCOLOGY, 2006, 24 (24) :3939-3945
[6]  
Bertheau P, 2005, ONCOL REP, V14, P513
[7]   Importance of tumor regression assessment in predicting the outcome in patients with locally advanced rectal carcinoma who are treated with preoperative radiotherapy [J].
Bouzourene, H ;
Bosman, FT ;
Seelentag, W ;
Matter, M ;
Coucke, P .
CANCER, 2002, 94 (04) :1121-1130
[8]  
Bramwell VHC, 1997, SEMIN ONCOL, V24, P561
[9]   Prognostic significance of a complete pathological response after induction chemotherapy in operable breast cancer [J].
Chollet, P ;
Amat, S ;
Cure, H ;
de Latour, M ;
Le Bouedec, G ;
Mouret-Reynier, MA ;
Ferriere, JP ;
Achard, JL ;
Dauplat, J ;
Penault-Llorca, F .
BRITISH JOURNAL OF CANCER, 2002, 86 (07) :1041-1046
[10]   Trends in long-term survival following liver resection for hepatic colorectal metastases [J].
Choti, MA ;
Sitzmann, JV ;
Tiburi, MF ;
Sumetchotimetha, W ;
Rangsin, R ;
Schulick, RD ;
Lillemoe, KD ;
Yeo, CJ ;
Cameron, JL .
ANNALS OF SURGERY, 2002, 235 (06) :759-765