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01-01-2014 | Hepatobiliary Tumors

Reconsideration of the Indications for Adjuvant Chemotherapy for Liver Metastases from Colorectal Cancer After Initial Hepatectomy

Authors: Fumitoshi Hirokawa, MD, Michihiro Hayashi, MD, Yoshiharu Miyamoto, MD, Mitsuhiro Asakuma, MD, Tetsunosuke Shimizu, MD, Koji Komeda, MD, Yoshihiro Inoue, MD, Kazuhisa Uchiyama, MD

Published in: Annals of Surgical Oncology | Issue 1/2014

Abstract

Background

The effectiveness of perioperative adjuvant chemotherapy for colorectal cancer liver metastasis (CRLM) remains a matter of debate. Despite the lack of clear evidence supporting its effectiveness after curative hepatectomy, adjuvant chemotherapy has been widely used clinically. The purpose of this study was to clarify the indications for adjuvant chemotherapy in order to develop an appropriate treatment strategy for CRLM.

Methods

The clinicopathological factors of 110 patients who underwent initial hepatectomy for CRLM between April 2000 and March 2010 were retrospectively analyzed. The prognostic factors of CRLM were identified and then CRLM was stratified according to the number of prognostic factors into the high-score group (H-group: score 2 or 3) and the low-score group (L-group: score 0 or 1), and the effectiveness of adjuvant chemotherapy was analyzed in each group.

Results

Multivariate analysis identified pT4 (p = 0.0047), lymph node metastasis in colorectal cancer (CRC) (p = 0.0165), and H2-classification (p = 0.0051) as factors related to a poor prognosis. The overall 5-year survival rate was markedly higher in the L-group (68 %) than in the H-group (26 %, p < 0.0001). Moreover, in the L-group, patients who did not receive adjuvant chemotherapy had the same prognosis as those who received adjuvant chemotherapy. As for recurrence, tumor relapse more often was treated by resection in the L-group than in the H-group (p = 0.0339).

Conclusions

Adjuvant chemotherapy did not improve overall survival and disease-free survival in patients with no more than two factors of the H2-classification, invasion depth pT4, and lymph node metastasis in CRC.

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Title: Reconsideration of the Indications for Adjuvant Chemotherapy for Liver Metastases from Colorectal Cancer After Initial Hepatectomy
Authors: Fumitoshi Hirokawa, MD
Michihiro Hayashi, MD
Yoshiharu Miyamoto, MD
Mitsuhiro Asakuma, MD
Tetsunosuke Shimizu, MD
Koji Komeda, MD
Yoshihiro Inoue, MD
Kazuhisa Uchiyama, MD
Publication date: 01-01-2014
Publisher: Springer US
Published in: Annals of Surgical Oncology / Issue 1/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-013-3310-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Reconsideration of the Indications for Adjuvant Chemotherapy for Liver Metastases from Colorectal Cancer After Initial Hepatectomy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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