188 research outputs found
The Effect of Histopathological Growth Patterns of Colorectal Liver Metastases on the Survival Benefit of Adjuvant Hepatic Arterial Infusion Pump Chemotherapy
Background: Histopathological growth patterns (HGPs) are a prognostic biomarker in colorectal liver metastases (CRLM). Desmoplastic HGP (dHGP) is associated with liver-only recurrence and superior overall survival (OS), while non-dHGP is associated with multi-organ recurrence and inferior OS. This study investigated the predictive value of HGPs for adjuvant hepatic arterial infusion pump (HAIP) chemotherapy in CRLM. Methods: Patients undergoing resection of CRLM and perioperative systemic chemotherapy in two centers were included. Survival outcomes and the predictive value of HAIP versus no HAIP per HGP group were evaluated through KaplanâMeier and Cox regression methods, respectively. Results:We included 1233 patients. In the dHGP group (n = 291, 24%), HAIP chemotherapy was administered in 75 patients (26%). In the non-dHGP group (n = 942, 76%), HAIP chemotherapy was administered in 247 patients (26%). dHGP was associated with improved overall survival (OS, HR 0.49, 95% CI 0.32â0.73, p < 0.001). HAIP chemotherapy was associated with improved OS (HR 0.61, 95% CI 0.45â0.82, p < 0.001). No interaction could be demonstrated between HGP and HAIP on OS (HR 1.29, 95% CI 0.72â2.32, p = 0.40).Conclusions: There is no evidence that HGPs of CRLM modify the survival benefit of adjuvant HAIP chemotherapy in patients with resected CRLM.</p
The patterns and timing of recurrence after curative resection for gastric cancer in China
Histopathological growth patterns as biomarker for adjuvant systemic chemotherapy in patients with resected colorectal liver metastases
Adjuvant systemic chemotherapy (CTx) is widely administered in patients with colorectal liver metastases (CRLM). Histopathological growth patterns (HGPs) are an independent prognostic factor for survival after complete resection. This study
evaluates whether HGPs can predict the efectiveness of adjuvant CTx in patients with resected CRLM. Two main types of
HGPs can be distinguished; the desmoplastic type and the non-desmoplastic type. Uni- and multivariable analyses for overall
survival (OS) and disease-free survival (DFS) were performed, in both patients treated with and without preoperative chemotherapy. A total of 1236 patients from two tertiary centers (Memorial Sloan Kettering Cancer Center, New York, USA; Erasmus MC Cancer Institute, Rotterdam, The Netherlands) were included (period 2000â2016). A total of 656 patients (53.1%)
patients received preoperative chemotherapy. Adjuvant CTx was only associated with a superior OS in non-desmoplastic
patients that had not been pretreated (adjusted hazard ratio (HR) 0.52, 95% confdence interval (CI) 0.37â0.73, p<0.001),
and not in desmoplastic patients (adjusted HR 1.78, 95% CI 0.75â4.21, p=0.19). In pretreated patients no signifcant efect
of adjuvant CTx was observed, neither in the desmoplastic group (adjusted HR 0.83, 95% CI 0.49â1.42, p=0.50) nor in
the non-desmoplastic group (adjusted HR 0.96, 95% CI 0.71â1.29, p=0.79). Similar results were found for DFS, with a
superior DFS in non-desmoplastic patients treated with adjuvant CTx (HR 0.71, 95% CI 0.55â0.93, p<0.001) that were not
pretreated. Adjuvant CTx seems to improve OS and DFS after resection of non-desmoplastic CRLM. However, this efect
was only observed in patients that were not treated with chemotherap
The Modified Glasgow Prognostic Score as a Predictor of Survival After Hepatectomy for Colorectal Liver Metastases
Patterns of Recurrence After Liver Transplantation for Nonresectable Liver Metastases from Colorectal Cancer
Recurrence After Liver Resection of Colorectal Liver Metastases: Repeat Resection or Ablation Followed by Hepatic Arterial Infusion Pump Chemotherapy
Background: The aim of this study was to investigate the effectiveness of adjuvant hepatic arterial infusion pump (HAIP) chemotherapy after complete resection or ablation of recurrent colorectal liver metastases (CRLM). Methods: A retrospective cohort study was conducted of patients from two centers who were treated with resection and/or ablation of recurrent CRLM only between 1992 and 2018. Overall survival (OS) and hepatic disease-free survival (hDFS) were estimated using the KaplanâMeier method. The Cox regression method was used to calculate hazard ratios (HRs) with corresponding 95% confidence intervals (CI). Results: Of 374 eligible patients, 81 (22%) were treated with adjuvant HAIP chemotherapy. The median follow-up for survivors was 65Â months (IQR 32â118Â months). Patients receiving adjuvant HAIP were more likely to have multifocal disease and receive perioperative systemic chemotherapy at time of resection for recurrence. A median hDFS of 46Â months (95% CI 29â81Â months) was found in patients treated with adjuvant HAIP compared with 18Â months (95% CI 15â26Â months) in patients treated with resection and/or ablation alone (p = 0.001). The median OS and 5-year OS were 89Â months (95% CI 52â126Â months) and 66%, respectively, in patients treated with adjuvant HAIP compared with 57Â months (95% CI 47â67Â months) and 47%, respectively, in patients treated with resection and/or ablation only (p = 0.002). Adjuvant HAIP was associated with superior hDFS (adjusted HR 0.599, 95% CI 0.38â0.93, p = 0.02) and OS (adjusted HR 0.59, 95% CI 0.38â0.92, p = 0.02) in multivariable analysis. Conclusion: Adjuvant HAIP chemotherapy after resection and/or ablation of recurrent CRLM is associated with superior hDFS and OS
Metastatic recurrence after complete resection of colorectal liver metastases: impact of surgery and chemotherapy on survival
Comparative sequencing analysis reveals high genomic concordance between matched primary and metastatic colorectal cancer lesions
ASO Author Reflections: Primary Tumor Location and Long-Term Survival After Hepatic Resection for Metastatic Colon Cancer
- âŠ