Association between imaging response and survival following neoadjuvant chemotherapy in patients with resectable colorectal liver metastases: A cohort study
Details
Publication Year 2021-04,Volume 123,Issue #5,Page 1263-1273
Journal Title
Journal of Surgical Oncology
Publication Type
Research article
Abstract
BACKGROUND: The association between the imaging response (structural or metabolic) to neoadjuvant chemotherapy (neoCT) before colorectal liver metastasis (CRLM) and survival is unclear. METHOD: A total of 201 patients underwent their first CRLM resection. A total of 94 (47%) patients were treated with neoCT. A multivariable, Cox proportional hazard regression analysis was performed to compare overall survival (OS) and progression-free survival (PFS) between response groups. RESULTS: Multivariable regression analysis of the CT/MRI (n = 94) group showed no difference in survival (OS and PFS) in patients who had stable disease/partial response (SD/PR) or complete response (CR) versus patients who had progressive disease (PD) (OS: HR, 0.36 (95% CI: 0.11-1.19) p = .094, HR, 0.78 (95% CI: 0.13-4.50) p = .780, respectively), (PFS: HR, 0.70 (95% CI: 0.36-1.35) p = .284, HR, 0.51 (0.18-1.45) p = .203, respectively). In the FDG-PET group (n = 60) there was no difference in the hazard of death for patients with SD/PR or CR versus patients with PD for OS or PFS except for the PFS in the small CR subgroup (OS: HR, 0.75 (95% CI: 0.11-4.88) p = .759, HR, 1.21 (95% CI: 0.15-9.43) p = .857), (PFS: HR, 0.34% (95% CI: 0.09-1.22), p = .097, HR, 0.17 (95% CI: 0.04-0.62) p = .008, respectively). CONCLUSION: There was no convincing evidence of association between imaging response to neoCT and survival following CRLM resection.
Keywords
Antineoplastic Combined Chemotherapy Protocols/*therapeutic use; Chemotherapy, Adjuvant/*mortality; Colorectal Neoplasms/diagnostic imaging/drug therapy/*mortality/pathology; Female; Follow-Up Studies; Humans; Liver Neoplasms/diagnostic imaging/drug therapy/*mortality/secondary; Male; Middle Aged; Neoadjuvant Therapy/*mortality; Neoplasm Recurrence, Local/diagnostic imaging/drug therapy/*mortality/pathology; Positron-Emission Tomography/*methods; Prognosis; Retrospective Studies; Survival Rate
Department(s)
Surgical Oncology; Medical Oncology
PubMed ID
33524184
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