Importance of response to neoadjuvant chemotherapy in patients undergoing resection of synchronous colorectal liver metastases
Importance of response to neoadjuvant chemotherapy in patients undergoing resection of synchronous colorectal liver metastases
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DOI：
10.1016/s1091-255x(02)00121-x
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发表时间：
2003-01-01
影响因子：
3.2
通讯作者：
Fong, Y
中科院分区：
文献类型：
--
作者：
Allen, PJ;Kemeny, N;Fong, Y
本研究的目的是比较分期切除同步结直肠肝转移患者的治疗和预后。本文回顾了1995年1月至2000年1月间行结肠或直肠切除术并进行临床可切除同步肝转移评估的患者记录。比较结肠切除术恢复后未接受新辅助化疗并行探查手术的患者与肝切除术前接受化疗的患者。在5年期间，共有106例患者接受了治疗。52例患者接受新辅助化疗；其中29名患者的病情没有进展，但有17名患者在接受治疗期间病情进展。中位随访时间为30个月。两组患者和肿瘤相关变量相似。接受新辅助化疗和未接受新辅助化疗的患者的5年生存率在统计学上相似（43% vs 35%， P=0.49）。与未接受化疗的患者相比，接受化疗期间疾病未进展的新辅助治疗组患者的生存率显著提高（85%对35%，P=0.03）。在同步结直肠肝转移的情况下，对新辅助化疗的反应可能是生存的预后指标，并可能有助于选择常规或实验性辅助治疗的患者。
The purpose of this study was to compare the treatment and outcome in patients referred for staged resection of synchronous colorectal liver metastases. The records of patients who had undergone colon or rectal resection and were then referred for evaluation of clinically resectable synchronous liver metastases between January 1995 and January 2000 were reviewed. Comparisons were made between patients who did not receive neoadjuvant chemotherapy and had exploratory operations after recovery from colon resection and patients who did receive chemotherapy before liver resection. A total of 106 patients were treated during the 5-year period. Neoadjuvant chemotherapy was given to 52 of the patients; in 29 of them the disease did not progress, but in 17 patients the disease progressed while they were receiving treatment. Median follow-up was 30 months. Patient- and tumor-related variables were similar between groups. Five-year survival was statistically similar between patients who did and those who did not receive neoadjuvant chemotherapy (43% vs. 35%, P=0.49). Patients within the neoadjuvant group whose disease did not progress while they were receiving chemotherapy experienced significantly improved survival as compared to patients who did not receive chemotherapy (85% vs. 35%, P=0.03). In the setting of synchronous colorectal liver metastases, the response to neoadjuvant chemotherapy may be a prognostic indicator of survival and may assist in the selection of patients for conventional or experimental adjuvant therapies.