Kang Mee-Young, Paik Jin-Hee, Ryu Chun-Geun, Hwang Dae-Yong
Department of Surgery, Colorectal Cancer Center, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
Ann Surg Treat Res. 2021 Sep;101(3):160-166. doi: 10.4174/astr.2021.101.3.160. Epub 2021 Aug 31.
We aimed to investigate whether adjuvant oxaliplatin-based chemotherapy after treatment for hepatic metastasis affects recurrence or survival and to determine the risk factors for recurrence or survival.
Forty-six patients who underwent curative treatment for hepatic metastasis from colorectal cancer between July 2009 and December 2017 were included from a retrospectively collected patient database. Curative resection included hepatic resection, radiofrequency ablation (RFA), or a combination of both, followed by adjuvant chemotherapy with oxaliplatin-based chemotherapy.
Thirty-seven patients (80.4%) had colon cancer and 9 (19.6%) had rectal cancer. Twenty-six patients (56.5%) underwent hepatic resection, 7 (15.2%) RFA, and 13 (28.3%) hepatic resection and RFA. Thirty-two patients (69.6%) underwent chemotherapy after hepatic treatment. The recurrence incidence was 50% in the non-chemotherapy group and 46.9% in the chemotherapy group (P > 0.999). The incidence of death was 7.1% in the non-chemotherapy group and 18.8% in the chemotherapy group (P = 0.657). The recurrence risk factors were N stage (N0 . N2; P = 0.013, P = 0.005) and bilobed hepatic metastasis (P = 0.027, P = 0.009) in the univariate and multivariate analyses, respectively. However, chemotherapy after hepatic treatment was not a risk factor for disease-free survival (DFS) or overall survival (OS) in the univariate and multivariate analyses (P = 0.656 and P = 0.414, respectively; P = 0.510 and P = 0.459, respectively).
Oxaliplatin-based adjuvant chemotherapy after colorectal hepatic metastasis treatment did not affect the DFS or OS. The N stage of the primary tumor and bilobed hepatic metastasis are risk factors for recurrence and death.
我们旨在研究结直肠癌肝转移治疗后基于奥沙利铂的辅助化疗是否会影响复发或生存情况，并确定复发或生存的危险因素。
从一个回顾性收集的患者数据库中纳入了2009年7月至2017年12月期间接受结直肠癌肝转移根治性治疗的46例患者。根治性切除包括肝切除、射频消融（RFA）或两者联合，随后进行基于奥沙利铂的辅助化疗。
37例（80.4%）为结肠癌患者，9例（19.6%）为直肠癌患者。26例（56.5%）接受了肝切除，7例（15.2%）接受了RFA，13例（28.3%）接受了肝切除和RFA。32例（69.6%）患者在肝脏治疗后接受了化疗。非化疗组的复发率为50%，化疗组为46.9%（P>0.999）。非化疗组的死亡率为7.1%，化疗组为18.8%（P=0.657）。单因素和多因素分析中，复发的危险因素分别为N分期（N0对N2；P=0.013，P=0.005）和双侧肝转移（P=0.027，P=0.009）。然而，在单因素和多因素分析中，肝脏治疗后化疗均不是无病生存期（DFS）或总生存期（OS）的危险因素（分别为P=0.656和P=0.414；分别为P=0.510和P=0.459）。
结直肠癌肝转移治疗后基于奥沙利铂的辅助化疗不影响DFS或OS。原发肿瘤的N分期和双侧肝转移是复发和死亡的危险因素。
