Prognostic factors for disease-free survival after preoperative chemotherapy followed by curative resection in patients with colorectal cancer harboring hepatic metastasis: a single-institute, retrospective analysis in Asia.
BACKGROUND
Converting chemotherapy followed by surgery is known to be associated with improved clinical outcomes in colorectal cancer (CRC) patients with hepatic metastasis. This study is to investigate the clinicopathological prognostic factors for disease-free survival (DFS) after curative resection of primary and metastatic lesions.


METHODS
We retrospectively analyzed the medical records of 76 CRC patients who had initially had unresectable hepatic metastasis, which was considered resectable after systemic chemotherapy, and had undergone curative surgery in the period from January 2006 to December 2011. DFS was compared by assessing clinical data including age, sex, staging, number of hepatic lesion(s), size of the largest hepatic lesion and serum carcinoembryonic antigen (CEA) levels.


RESULTS
The median age was 57 years and 47 patients were male. The median DFS was 10.4 months. Multivariate Cox regression analysis revealed that age <50 years (HR 2.70, 95% CI 1.43-5.10, p = 0.002) and CEA elevation after curative surgery (HR 2.20, 95% CI 1.11-4.36, p = 0.023) were associated with a shorter DFS.


CONCLUSIONS
Given that patients <50 years old or with elevated CEA levels after curative surgery demonstrated a short DFS, additional postoperative systemic treatment or active surveillance, at least, should strongly be considered for this group.
Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.
Jun Ho
JH
Yi
Hyunki
H
Kim
Minkyu
M
Jung
Sang Joon
SJ
Shin
Jin Sub
JS
Choi
Gi-Hong
GH
Choi
Seung Hyuk
SH
Baik
Byung Soh
BS
Min
Nam Kyu
NK
Kim
Joong Bae
JB
Ahn
D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D000068258:Bevacizumab; D014408:Biomarkers, Tumor / Q000097:blood*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D002272:Carcinoembryonic Antigen / Q000097:blood*; D000068818:Cetuximab; D003082:Colectomy; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000601:surgery / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000556:secondary* / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020360:Neoadjuvant Therapy / Q000379:methods*; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
D061067:Antibodies, Monoclonal, Humanized; D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D009944:Organoplatinum Compounds; D000068258:Bevacizumab; D000068818:Cetuximab; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin