Impact of Preoperative Chemotherapy Features on Patient Outcomes after Hepatectomy for Initially Unresectable Colorectal Cancer Liver Metastases: A LiverMetSurvey Analysis.
Pasquale F InnominatoValérie CailliezMarc-Antoine AllardSantiago Lopez-BenAlessandro FerreroHugo Pinto MarquesCatherine HubertFelice GiulianteFernando PereiraEsteban CugatDarius F MirzaJose Costa-MaiaAlejandro SerrabloReal LapointeCristina DopazoJose TralhaoGernot KaiserJinn-Shiun ChenFrancisco Garcia-BorobiaJean-Marc RegimbeauOleg SkipenkoJen-Kou LinChristophe LaurentEnrico OpocherYuichi GotoBenoist ChibaudelAimery de GramontRené AdamPublished in: Cancers (2022)
Background: Prognostic factors have been extensively reported after resection of colorectal liver metastases (CLM); however, specific analyses of the impact of preoperative systemic anticancer therapy (PO-SACT) features on outcomes is lacking. Methods: For this real-world evidence study, we used prospectively collected data within the international surgical LiverMetSurvey database from all patients with initially-irresectable CLM. The main outcome was Overall Survival (OS) after surgery. Disease-free (DFS) and hepatic-specific relapse-free survival (HS-RFS) were secondary outcomes. PO-SACT features included duration (cumulative number of cycles), choice of the cytotoxic backbone (oxaliplatin- or irinotecan-based), fluoropyrimidine (infusional or oral) and addition or not of targeted monoclonal antibodies (anti-EGFR or anti-VEGF). Results: A total of 2793 patients in the database had received PO-SACT for initially irresectable diseases. Short (<7 or <13 cycles in 1st or 2nd line) PO-SACT duration was independently associated with longer OS (HR: 0.85 p = 0.046), DFS (HR: 0.81; p = 0.016) and HS-RFS (HR: 0.80; p = 0.05). All other PO-SACT features yielded basically comparable results. Conclusions: In this international cohort, provided that PO-SACT allowed conversion to resectability in initially irresectable CLM, surgery performed as soon as technically feasible resulted in the best outcomes. When resection was achieved, our findings indicate that the choice of PO-SACT regimen had a marginal if any, impact on outcomes.
Keyphrases
- liver metastases
- prognostic factors
- free survival
- visible light
- end stage renal disease
- small cell lung cancer
- patients undergoing
- chronic kidney disease
- type diabetes
- peritoneal dialysis
- coronary artery disease
- metabolic syndrome
- squamous cell carcinoma
- locally advanced
- electronic health record
- minimally invasive
- epidermal growth factor receptor
- machine learning
- skeletal muscle
- bone marrow
- data analysis
- deep learning
- rectal cancer
- big data
- anti inflammatory
- decision making
- vascular endothelial growth factor