Is there a survival benefit from adjuvant chemotherapy for patients with liver oligometastases from colorectal cancer after curative resection?  

作　　者：Zhizhong Pan Jianhong Peng Junzhong Lin Gong Chen Xiaojun Wu Zhenhai Lu Yuxiang Deng Yujie Zhao Qiaoqi Sui Desen Wan 

机构地区：[1]Department of Colorectal Surgery,Sun Yat-sen University Cancer Center,State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine,651 Dongfeng Road East,Guangzhou 510060,Guangdong,P.R.China

出　　处：《Cancer Communications》2018年第1期319-328,共10页癌症通讯（英文）

基　　金：funded by the National Natural Science Foundation of China(No.81772595);Sun Yat-sen University Clinical Research 5010 Program(2015024);Sun Yat-sen University Clinical Research 5010 Program(2013013);Science and Technology Planning Project of Guangdong Province(Grant No.2013B021800146).

摘　　要：Background:Although colorectal oligometastases to the liver can potentially be cured with aggressive local abla-tion,the efficacy of adjuvant chemotherapy(ACT)for such metastasis remains unclear.The present study explored the effects of ACT on patients with colorectal liver oligometastases(CLO)after curative resections and aimed to iden-tify patients who could benefit from ACT.Methods:We retrospectively analyzed 264 eligible patients with CLO who underwent curative resection between September 1999 and June 2015.Recurrence-free survival(RFS)and overall survival(OS)were analyzed using the Kaplan-Meier method and log-rank test;prognostic factors were a by Cox regression modeling.Results:Among 264 patients,200(75.8%)patients received ACT and 64(24.2%)did not receive ACT.These two groups did not significantly differ in clinicopathologic characteristics,and had comparable 3-year OS and RFS rates(RFS:42.1%vs.45.7%,P=0.588;OS:69.7%vs.62.7%,P=0.446)over a median follow-up duration of 35.5 months,irrespective of preoperative chemotherapy.ACT markedly improved 3-year OS in high-risk patients with Memorial Sloan-Kettering Cancer Center clinical risk scores(MSKCC-CRS)of 3-5(68.2%vs.33.8%,P=0.015),but presented no additional benefit in patients with MSKCC-CRS of 0-2(72.2%vs.78.6%,P=0.834).In multivariate analysis,ACT was independently associated with improved OS in patients with MSKCC-CRS of 3-5.Conclusions:ACT might offer a prognostic benefit in high-risk patients with CLOs after curative liver resection,but not in low-risk patients.Therefore,patients’risk status should be determined before ACT administration to optimize postoperative therapeutic strategies.

关 键 词：Colorectal cancer OLIGOMETASTASES Adjuvant chemotherapy Liver resection BENEFIT 

分 类 号：R73[医药卫生—肿瘤]