Long-term clinical outcomes after the second metastasectomy in patients with resected metastatic colorectal cancer

IF 2.5 4区医学 Q3 ONCOLOGY

Current Problems in Cancer Pub Date : 2024-10-22 DOI:10.1016/j.currproblcancer.2024.101151

Songji Choi , Minsu Kang , Ji-Won Kim , Jin Won Kim , Jae Hyun Jeon , Heung-Kwon Oh , Hae Won Lee , Jai Young Cho , Duck-Woo Kim , Sukki Cho , Jee Hyun Kim , Kwhanmien Kim , Sung-Bum Kang , Sanghoon Jheon , Keun-Wook Lee

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引用次数: 0

Abstract

Purpose

Primary tumor resection and metastasectomy are curative for metastatic colorectal cancer. However, there is still a paucity of data regarding the clinical outcomes and risk factors after disease recurrence and second metastasectomy.

Materials and Methods

We retrospectively evaluated the clinical outcomes of patients who underwent the second metastasectomy. In addition, risk factors for the outcomes were analyzed.

Results

A total of 94 patients (39 females and 55 males) received a second metastasectomy after the recurrence. Recurrent sites included the lung (47 patients), liver (36 patients), both lung and liver (four patients), and non-lung/non-liver (seven patients). Among them, 89 (94.7 %) patients achieved R0 resection, while three (3.2 %) and two (2.1 %) patients achieved R1 and R2 resections, respectively. The 5-year disease-free survival (DFS) and overall survival (OS) were 42.8±5.3 % and 67.2±4.9 %, respectively. Multivariable analysis for DFS identified that primary rectal cancer (hazard ratio [HR] 0.45, P=0.033) and disease-free interval after the first metastasectomy of ≥12 months (HR 0.39, P=0.002) were good predictive factors; in contrast, non-lung/non-liver metastasis (HR 3.32, P=0.020) was a poor predictive factor. Multivariable analysis for OS showed that age ≥70 years (HR 3.27, P=0.011), non-lung/non-liver metastasis (HR 4.04, P=0.024), and lesion number ≥2 (HR 2.25, P=0.023) were poor prognostic factors.

Conclusion

Patients who underwent a second metastasectomy had a long-term disease-free state and good OS. Our data suggest that a second metastasectomy should be considered if a patient has a limited number of metastases confined to the liver and/or lung and long DFS after the first metastasectomy.

查看原文本刊更多论文

切除转移性结直肠癌患者第二次转移切除术后的长期临床疗效。

目的：原发肿瘤切除术和转移灶切除术可治愈转移性结直肠癌。然而，关于疾病复发和二次转移切除术后的临床结果和风险因素的数据仍然很少：我们回顾性评估了接受二次转移切除术患者的临床结局。此外，还分析了影响结果的风险因素：共有 94 名患者（39 名女性和 55 名男性）在复发后接受了第二次转移灶切除术。复发部位包括肺部（47 例）、肝脏（36 例）、肺部和肝脏（4 例）以及非肺部/非肝脏（7 例）。其中，89 名（94.7%）患者实现了 R0 切除，3 名（3.2%）和 2 名（2.1%）患者分别实现了 R1 和 R2 切除。5年无病生存率（DFS）和总生存率（OS）分别为（42.8±5.3%）和（67.2±4.9%）。DFS的多变量分析表明，原发性直肠癌（危险比[HR] 0.45，P=0.033）和首次转移灶切除术后无病间隔≥12个月（HR 0.39，P=0.002）是良好的预测因素；相比之下，非肺/非肝转移（HR 3.32，P=0.020）是不良的预测因素。OS的多变量分析显示，年龄≥70岁（HR 3.27，P=0.011）、非肺/非肝转移（HR 4.04，P=0.024）和病灶数≥2（HR 2.25，P=0.023）是不良预后因素：结论：接受第二次转移灶切除术的患者具有长期无病状态和良好的OS。我们的数据表明，如果患者的转移灶局限于肝脏和/或肺部，且第一次转移灶切除术后的DFS较长，则应考虑进行第二次转移灶切除术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Problems in Cancer 医学-肿瘤学

CiteScore

5.10

自引率

0.00%

发文量

审稿时长

15 days

期刊介绍： Current Problems in Cancer seeks to promote and disseminate innovative, transformative, and impactful data on patient-oriented cancer research and clinical care. Specifically, the journal''s scope is focused on reporting the results of well-designed cancer studies that influence/alter practice or identify new directions in clinical cancer research. These studies can include novel therapeutic approaches, new strategies for early diagnosis, cancer clinical trials, and supportive care, among others. Papers that focus solely on laboratory-based or basic science research are discouraged. The journal''s format also allows, on occasion, for a multi-faceted overview of a single topic via a curated selection of review articles, while also offering articles that present dynamic material that influences the oncology field.