Institute of Clinical Radiology, University Hospital Münster, Münster, Germany,
Institute of Clinical Radiology, University Hospital Münster, Münster, Germany.
Dig Dis. 2021;39(4):351-357. doi: 10.1159/000512744. Epub 2020 Nov 3.
Metastatic colorectal cancer (mCRC) is associated with different molecular biology, clinical characteristics, and outcome depending on the primary tumor localization. We aimed to evaluate the effectiveness of 90Y-radioembolization (RE) for therapy of colorectal liver metastases depending on the primary tumor side.
We performed a retrospective analysis of n = 73 patients with mCRC and RE in our university liver center between 2009 and 2018. Patients were stratified according to the primary tumor side (left vs. right hemicolon), treatment response was assessed by the Response Evaluation Criteria in Solid Tumors (RECIST) at follow-up after 3 months. Kaplan-Meier analysis was performed to analyze survival followed by Cox regression to determine independent prognostic factors for survival.
Prior to RE, all patients had received systemic therapy, with either stable or progressive disease, but no partial or complete response. In n = 22/73 (30.1%) patients, the primary tumor side was in the right colon; in n = 51/73 (69.9%) patients, in the left colon. Hepatic tumor burden was ≤25% in n = 36/73 (49.3%) patients and >25% in n = 37/73 (50.7%) patients. At 3 months, n = 21 (33.8%) patients showed treatment response (n = 2 [3.2%]; complete response, n = 19 [30.6%]; partial response), n = 13 (21.0%) stable disease, and n = 28 (45.2%) progressive disease after RE. The median survival in case of primary tumor side in the left colon was significantly higher than for primary tumors in the right colon (8.7 vs. 6.0 months, p = 0.033). The median survival for a hepatic tumor burden ≤25% was significantly higher than that of >25% (13.9 vs. 4.3 months, p < 0.001). The median overall survival was 6.1 months.
The median survival after RE in hepatic-mCRC depends on the primary tumor side and the preprocedural hepatic tumor burden.
转移性结直肠癌（mCRC）与原发性肿瘤定位相关的不同分子生物学、临床特征和预后有关。我们旨在评估 90Y 放射性栓塞（RE）治疗结直肠癌肝转移的效果，取决于原发性肿瘤侧。
我们对 2009 年至 2018 年期间在我们大学肝脏中心接受 mCRC 和 RE 治疗的 n = 73 例患者进行了回顾性分析。根据原发性肿瘤侧（左半结肠与右半结肠）进行分层，在 3 个月随访时通过实体瘤反应评估标准（RECIST）评估治疗反应。采用 Kaplan-Meier 分析进行生存分析，采用 Cox 回归确定生存的独立预后因素。
在 RE 之前，所有患者均接受了系统治疗，病情稳定或进展，但无部分或完全缓解。在 n = 73 例患者中，n = 22 例（30.1%）的原发性肿瘤位于右侧；n = 51 例（69.9%）位于左侧。n = 36 例（49.3%）患者的肝肿瘤负荷≤25%，n = 37 例（50.7%）患者的肝肿瘤负荷>25%。在 3 个月时，n = 21 例（33.8%）患者出现治疗反应（n = 2 [3.2%]；完全缓解，n = 19 [30.6%]；部分缓解），n = 13 例（21.0%）病情稳定，n = 28 例（45.2%）病情进展。左侧原发性肿瘤的中位生存期明显长于右侧（8.7 个月 vs. 6.0 个月，p = 0.033）。肝肿瘤负荷≤25%的中位生存期明显长于>25%的中位生存期（13.9 个月 vs. 4.3 个月，p < 0.001）。中位总生存期为 6.1 个月。
RE 后肝转移性 mCRC 的中位生存期取决于原发性肿瘤侧和术前肝肿瘤负荷。
