Long-term postoperative survival prediction in patients with colorectal liver metastasis

Wang, Kun; Liu, Wei; Yan, Xieqiao; Li, Juan; Xing, Baocai

doi:10.18632/oncotarget.20322

Cited by 36 publications

(27 citation statements)

References 32 publications

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“…Another limitation is the retrospective nature of this study, so the conclusion should be evaluated by large prospective controlled trials in future work. The third limitation is the loss of information regarding the response to preoperative chemotherapy as a referral center, which has been shown in previous work to be a pivotal prognostic factor for CRLM patients undergoing hepatectomy [ 34 , 38 ]. Finally, the fourth limitation was that the chemotherapy regimes had changed during so long study interval.…”

Section: Discussionmentioning

confidence: 99%

Liver resection for colorectal liver-limited metastases in elderly patients: a propensity score matching analysis

et al. 2020

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Background Few studies have focused on the role of hepatectomy for colorectal liver-limited metastases in elderly patients compared to matched younger patients. Methods From January 2000 to December 2018, 724 patients underwent hepatectomy for colorectal liver-limited metastases. Based on a 1:2 propensity score matching (PSM) model, 64 elderly patients (≥ 70 years of age) were matched to 128 younger patients (< 70 years of age) to obtain two balanced groups with regard to demographic, therapeutic, and prognostic factors. Results There were 73 elderly and 651 younger patients in the unmatched cohort. Compared with the younger group (YG), the elderly group (EG) had significantly higher proportion of American Society of Anesthesiologists score III and comorbidities and lower proportion of more than 3 liver metastases and postoperative chemotherapy (p < 0.05). After PSM for these factors, rat sarcoma virus proto-oncogene/B-Raf proto-oncogene (RAS/BRAF) mutation status and primary tumor sidedness, the EG had significantly less median intraoperative blood loss than the YG (175 ml vs. 200 ml, p = 0.046), a shorter median postoperative hospital stay (8 days vs. 11 days, p = 0.020), and a higher readmission rate (4.7% vs.0%, p = 0.036). The EG also had longer disease-free survival (DFS), overall survival (OS), and cancer-specific survival (CSS) compared to the YG, but these findings were not statistically significant (p > 0.05). Old age was not an independent factor for DFS, OS, and CSS by Cox multivariate regression analysis (p > 0.05). Conclusions Hepatectomy is safe for colorectal liver-limited metastases in elderly patients, and these patients may subsequently benefit from prolonged DFS, OS, and CSS.

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Section: Discussionmentioning

confidence: 99%

Liver resection for colorectal liver-limited metastases in elderly patients: a propensity score matching analysis

et al. 2020

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“…Once patients develop colorectal liver metastasis (CRLM), their prognosis significantly deteriorates and hepatic resection offers the only chance of cure. Five‐year disease free survival (DFS) is reportedly 24% for patients undergoing hepatic resection for CRLM . Despite the apparent survival benefit offered by hepatic resection, clinical and experimental evidence suggests that hepatic resection may drive the development of further metastases .…”

Section: Introductionmentioning

confidence: 99%

Searching for the link; mechanisms underlying liver regeneration and recurrence of colorectal liver metastasis post partial hepatectomy

Riddiough

Fifis

Muralidharan

et al. 2019

J of Gastro and Hepatol

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Despite excellent treatment of primary colorectal cancer, the majority of deaths occur as a result of metastasis to the liver. Recent population studies have estimated that one quarter of patients with colorectal cancer will incur synchronous or metachronous colorectal liver metastasis. However, only one quarter of these patients will be eligible for potentially curative resection. Tumor recurrence occurs in reportedly 60% of patients undergoing hepatic resection, and the majority of intrahepatic recurrence occurs within the first 6 months of surgery. The livers innate ability to restore its homeostatic size, and volume facilitates major hepatic resection that currently offers the only chance of cure to patients with extensive hepatic metastases. Experimental and clinical evidence supports the notion that following partial hepatectomy, liver regeneration (LR) paradoxically drives tumor progression and increases the risk of recurrence. It is becoming increasingly clear that the processes that drive liver organogenesis, regeneration, and tumor progression are inextricably linked. This presents a major hurdle in the management of colorectal liver metastasis and other hepatic malignancies because therapies that reduce the risk of recurrence without hampering LR are sought. The processes and pathways underlying these phenomena are multiple, complex, and cross‐communicate. In this review, we will summarize the common mechanisms contributing to both LR and tumor recurrence.

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“…Another limitation is the retrospective nature of this study; so the conclusion should be evaluated by large prospective controlled trials in future work. Finally, the third limitation is the loss of information regarding the response to preoperative chemotherapy, which has been shown in previous work to be a pivotal prognostic factor for CRLM patients undergoing hepatectomy [31,35].…”

Section: Discussionmentioning

confidence: 99%

Liver Resection for Colorectal Liver-limited Metastases in Elderly Patients: A Propensity Score Matching Analysis

Jin

Wang

Bao

et al. 2020

Preprint

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Background: Few studies have focused on the role of hepatectomy for colorectal liver-limited metastases in elderly patients compared to matched younger patients.Methods: From January 2000 to December 2018, 724 patients underwent hepatectomy for colorectal liver-limited metastases. Based on a 1:2 propensity score matching (PSM) model, 64 elderly patients (≥ 70 years of age) were matched to 128 younger patients (༜70 years of age) to obtain two balanced groups with regards to demographic, therapeutic and prognostic factors.Results: There were 73 elderly and 651 younger patients in the unmatched cohort. Compared with the younger group (YG), the elderly group (EG) had significantly higher proportion of American Society of Anesthesiologists score Ⅲ and comorbidities, and lower proportion of more than 3 liver metastases and postoperative chemotherapy (p < 0.05). After PSM for these factors, rat sarcoma virus proto-oncogene/B-Raf proto-oncogene (RAS/BRAF) mutation status and primary tumor sidedness, the EG had significantly less median intraoperative blood loss than the YG (175 ml vs. 200 ml, p = 0.046), a shorter median postoperative hospital stay (8 days vs. 11 days, p = 0.020) and a higher readmission rate (4.7% vs.0%, p = 0.036). The EG also had longer disease-free survival (DFS), overall survival (OS) and cancer-specific survival (CSS) compared to the YG, but these findings were not statistically significant (p > 0.05). Old age was not an independent factor for DFS, OS and CSS by Cox multivariate regression analysis (p > 0.05).Conclusions: Hepatectomy is safe for colorectal liver-limited metastases in elderly patients, and these patients may subsequently benefit from prolonged DFS, OS and CSS.

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Long-term postoperative survival prediction in patients with colorectal liver metastasis

Cited by 36 publications

References 32 publications

Liver resection for colorectal liver-limited metastases in elderly patients: a propensity score matching analysis

Liver resection for colorectal liver-limited metastases in elderly patients: a propensity score matching analysis

Searching for the link; mechanisms underlying liver regeneration and recurrence of colorectal liver metastasis post partial hepatectomy

Liver Resection for Colorectal Liver-limited Metastases in Elderly Patients: A Propensity Score Matching Analysis

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