Adjuvant chemotherapy for isolated resectable colorectal lung metastasis: A retrospective study using inverse probability treatment weighting propensity analysis  

作　　者：Zhao Gao Shi-Kai Wu Shi-Jie Zhang Xin Wang Ying-Chao Wu Xuan Jin 

机构地区：[1]Department of Medical Oncology,Peking University First Hospital,Beijing 100034,China [2]Department of Thoracic Surgery,Peking University First Hospital,Beijing 100034,China [3]Department of Gastrointestinal Surgery,Peking University First Hospital,Beijing 100034,China

出　　处：《World Journal of Gastrointestinal Surgery》2024年第10期3171-3184,共14页世界胃肠外科杂志（英文）

基　　金：Supported by the National Project for Clinical Key Specialty Development.

摘　　要：BACKGROUND The benefit of adjuvant chemotherapy(ACT)for patients with no evidence of disease after pulmonary metastasis resection(PM)from colorectal cancer(CRC)remains controversial.AIM To assess the efficacy of ACT in patients after PM resection for CRC.METHODS This study included 96 patients who underwent pulmonary metastasectomy for CRC at a single institution between April 2008 and July 2023.The primary end-point was overall survival(OS);secondary endpoints included cancer-specific survival(CSS)and disease-free survival(DFS).An inverse probability of treat-ment-weighting(IPTW)analysis was conducted to address indication bias.Sur-vival outcomes compared using Kaplan-Meier curves,log-rank test,Cox regre-ssion and confirmed by propensity score-matching(PSM).RESULTS With a median follow-up of 27.5 months(range,18.3-50.4 months),the 5-year OS,CSS and DFS were 72.0%,74.4%and 51.3%,respectively.ACT had no significant effect on OS after PM resection from CRC[original cohort:P=0.08;IPTW:P=0.15].No differences were observed for CSS(P=0.12)and DFS(P=0.68)between the ACT and non-ACT groups.Multivariate analysis showed no association of ACT with better survival,while sublobar resection(HR=0.45;95%CI:0.20-1.00,P=0.049)and longer disease-free interval(HR=0.45;95%CI:0.20-0.98,P=0.044)were associated with improved survival.CONCLUSION ACT does not improve survival after PM resection for CRC.Further well-designed randomized controlled trials are needed to determine the optimal ACT regimen and duration.

关 键 词：Colorectal cancer Resection of pulmonary metastasis Adjuvant chemotherapy Inverse probability treatment weighting Prognosis 

分 类 号：R735.34[医药卫生—肿瘤]