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Prognostic implications of margin status in association with systemic treatment in a cohort study of patients with resection of colorectal liver metastases.
Moaven, Omeed; Mainali, Bigyan B; Valenzuela, Cristian D; Russell, Gregory; Cheung, Tanto; Corvera, Carlos U; Wisneski, Andrew D; Cha, Charles H; Stauffer, John A; Shen, Perry.
Afiliación
  • Moaven O; Division of Surgical Oncology, Department of Surgery, Louisiana State University (LSU) Health, New Orleans, Louisiana, USA.
  • Mainali BB; LSU-LCMC Cancer Center, New Orleans, Louisiana, USA.
  • Valenzuela CD; Department of Surgical Oncology, Comprehensive Cancer Center, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA.
  • Russell G; Department of Surgical Oncology, Comprehensive Cancer Center, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA.
  • Cheung T; Department of Surgical Oncology, Comprehensive Cancer Center, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA.
  • Corvera CU; Department of Surgery, University of Hong Kong, Pok Fu Lam, Hong Kong.
  • Wisneski AD; Department of Hepatobiliary & Pancreatic Surgery, University of California San Francisco, San Francisco, California, USA.
  • Cha CH; Department of Hepatobiliary & Pancreatic Surgery, University of California San Francisco, San Francisco, California, USA.
  • Stauffer JA; Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA.
  • Shen P; Department of Surgical Oncology, Mayo Clinic in Florida, Jacksonville, Florida, USA.
J Surg Oncol ; 2024 Aug 25.
Article en En | MEDLINE | ID: mdl-39183490
ABSTRACT

BACKGROUND:

This study investigates the impact of margin status after colorectal liver metastasis (CLM) resection on outcomes of patients after neoadjuvant treatment versus those who underwent upfront resection.

METHODS:

An international collaborative database of CLM patients who underwent surgical resection was used. Proportional hazard regression models were created for single and multivariable models to assess the relationship between independent measures and median overall survival (mOS).

RESULTS:

R1 was associated with worse OS in the neoadjuvant group (mOS 51.8 m for R0 vs. 26.0 m for R1; HR 2.18). In the patients who underwent upfront surgery, R1 was not associated with OS. (mOS 46.7 m for R0 vs. 42.6 m for R1). When patients with R1 in each group were stratified by adjuvant treatment, there was no significant difference in the neoadjuvant group, while in the upfront surgery group with R1, adjuvant treatment was associated with significant improvement in OS (mOS 42.6 m for adjuvant vs. 25.0 m for no adjuvant treatment; HR 0.21).

CONCLUSION:

R1 is associated with worse outcomes in the patients who receive neoadjuvant treatment with no significant improvement with the addition of adjuvant therapy, likely representing an aggressive tumor biology. R1 did not impact OS in patients with upfront surgery who received postoperative chemotherapy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Surg Oncol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Surg Oncol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos