Hernández-Yagüe Xavier, López-Ben Santiago, Martínez-Sancho Joan, Ortíz-Durán Maria Rosa, Casellas-Robert Margarida, Aula-Olivar Ana, Meléndez-Muñoz Cristina, Pujolràs Maria Buxó, Queralt-Merino Bernardo, Felip Joan Figueras I
Department of Medical Oncology, Catalan Institute of Oncology, Doctor Josep Trueta University Hospital, Av. França s/n, 17007 Girona, Spain.
Hepatobiliary and Pancreatic Surgery Unit, Department of Surgery, Dr. Josep Trueta Hospital, IdIBGi, 17007 Girona, Spain.
Cancers (Basel). 2025 Jun 3;17(11):1870. doi: 10.3390/cancers17111870.
Colorectal cancer (CRC) is a significant global health burden, with liver metastases representing a key prognostic factor. Neoadjuvant chemotherapy (NAC) has improved outcomes in metastatic CRC (mCRC), and tumor regression is commonly assessed using the Rubbia-Brandt classification. The Poultsides classification defines ≥40% fibrosis as an independent prognostic factor, particularly in patients treated with cetuximab (45.71%). However, the predictive value of this threshold remains under debate, warranting further investigation. This study evaluates the extent of fibrosis (≥40%) induced by NAC plus anti-epidermal growth factor receptor (anti-EGFR) therapy vs. NAC plus anti-vascular endothelial growth factor (anti-VEGF) therapy in mCRC patients. It also examines the prognostic relevance of the Poultsides and Rubbia-Brandt classifications. A total of 108 patients undergoing liver resection for CRC metastases were included. Statistical analyses were performed using SPSS 28.0 version and R software 4.5 version to compare fibrosis rates and survival outcomes. From September 2005 to January 2023, 108 patients were analyzed: 54 received chemotherapy plus anti-EGFR (Cohort 1), and 54 received chemotherapy plus anti-VEGF (Cohort 2). Fibrosis was significantly higher in Cohort 1 (median 40.0%, IQR: 25.4-53.2) than in Cohort 2 (median 20.6%, IQR: 8.07-36.9), < 0.001. Overall survival was similar between both cohorts ( = 0.96), with a median follow-up of 41.6 months. Anti-EGFR therapy is associated with greater fibrosis than anti-VEGF, despite similar survival outcomes. The Poultsides classification may be a useful prognostic tool for resected liver metastases in mCRC.
结直肠癌（CRC）是一项重大的全球健康负担，肝转移是一个关键的预后因素。新辅助化疗（NAC）改善了转移性结直肠癌（mCRC）的治疗结果，肿瘤退缩通常使用鲁比亚 - 布兰特分类法进行评估。波尔齐德斯分类法将≥40%的纤维化定义为一个独立的预后因素，特别是在接受西妥昔单抗治疗的患者中（45.71%）。然而，这个阈值的预测价值仍存在争议，值得进一步研究。本研究评估了NAC联合抗表皮生长因子受体（抗EGFR）治疗与NAC联合抗血管内皮生长因子（抗VEGF）治疗在mCRC患者中诱导的纤维化程度（≥40%）。它还研究了波尔齐德斯和鲁比亚 - 布兰特分类法的预后相关性。共有108例因CRC转移接受肝切除术的患者纳入研究。使用SPSS 28.0版本和R软件4.5版本进行统计分析，以比较纤维化率和生存结果。从2005年9月至2023年1月，对108例患者进行了分析：54例接受化疗加抗EGFR（队列1），54例接受化疗加抗VEGF（队列2）。队列1中的纤维化明显高于队列2（中位数40.0%，四分位间距：25.4 - 53.2），而队列2为（中位数20.6%，四分位间距：8.07 - 36.9），<0.001。两个队列的总生存期相似（=0.96），中位随访时间为41.6个月。尽管生存结果相似，但抗EGFR治疗比抗VEGF治疗导致的纤维化更严重。波尔齐德斯分类法可能是mCRC中切除肝转移灶的一个有用的预后工具。
