Intentional R1 resection of liver metastases: A new treatment paradigm for patients with advanced colorectal cancer based on a propensity score–Matched case-control analysis - 31/03/23
Highlights |
• | Colorectal cancer liver metastases (CRCLM) should be resected when feasible |
• | Preoperative choice of intentional microscopic incomplete CRCLM resection is valid |
• | Such surgical strategy must be provided to highly selected patients |
Abstract |
Background |
Clinical outcomes of colorectal cancer (CRC) patients after an incomplete microscopic (R1) resection of liver metastases may not differ from those following a microscopically margin negative (R0) resection, when the latest is not feasible because of anatomic issues. We aimed at comparing the clinical outcomes of CRC patients with an intentional R1 or with a R0 resection of liver metastases.
Methods |
All patients with advanced in CRC and liver metastases consecutively treated by liver resection between February 2005 and January 2019 at in the department of Digestive and Hepatobiliary Surgery of Henri Mondor University Hospital (Créteil, France) were included in this retrospective case-control study. Overall survival (OS) and event-free survival (EFS) were compared between patients who underwent an intentional (pre-operative decision) R1 resection (iR1) to those who had a R0 resection of liver metastases. To account for confounding, comparison between the 2 groups was performed after adjustment using propensity score analysis.
Results |
Twenty-six CRC patients treated by iR1 resection of liver metastases were compared to 98 patients treated by R0 resection. Median OS reached 39 months [95% confidence interval (CI): 25-67] and 63 months [95% CI: 52-76] in the iR1 and R0 groups, respectively. After adjustment by inverse probability of treatment weighting, patients’ OS and EFS did not differ significantly between the iR1 and R0 groups (hazard ratio (HR): 1.19 [0.54-2.62] and 1.67 [0.93-3.03]), respectively.
Conclusion |
iR1 resection of liver metastases in advanced CRC patients is an acceptable therapeutic strategy, when R0 resection is not feasible.
Le texte complet de cet article est disponible en PDF.Keywords : (MeSHterms) hepatectomy, Colorectal neoplasms, Propensity score, Metastasectomy
Plan
Vol 47 - N° 4
Article 102097- avril 2023 Retour au numéro
Article précédent
- Timing of minimally invasive step-up intervention for symptomatic pancreatic necrotic fluid collections: A systematic review and meta-analysis
- ZheYu Liu, Pi Liu, Xuan Xu, Qian Yao, YuWen Xiong
- Trop-2 is a ubiquitous and promising target in pancreatic adenocarcinoma
- L. Mas, J. Cros, M. Svrcek, J.L. Van Laethem, J.F. Emile, V. Rebours, R. Nicolle, J.B. Bachet
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?