577P - Extensive liver resections and preoperative regional intraarterial chemotherapy in patients with liver colorectal cancer metastases and unfavourable...

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Colon Cancer
Rectal Cancer
Surgery and/or Radiotherapy of Cancer
Presenter Sergey Khays
Authors S. Khays1, K. Mamontov2, A. Kotelnikov3, S. Lazarev2, A. Lazarev4
  • 1Altai Branch of N. N. Blokhin Russian Cancer Research Centre, Barnaul/RU
  • 2Liver And Pancreas Surgery, Altai Branch of N. N. Blokhin Russian Cancer Research Centre, 656015 - Barnaul/RU
  • 3Liver And Pancreas Surgery, N. N. Blokhin Russian Cancer Research Centre, Moscow/RU
  • 4Chief Of Altai Branch Of N. N. Blokhin Russian Cancer Research Centre, Altai Branch of N. N. Blokhin Russian Cancer Research Centre, 656049 - Barnaul/RU

Abstract

Objective

To analyze patients with negative prognostic factors, as well as overall and disease-free survival.

Materials and methods

101 patients with liver colorectal cancer metastases were enrolled in this local observational study. All patients undergone preoperative regional intraarterial chemo- or biotherapy (group 1 - FOLFOX 6, group 2 - FOLFOX 6 + bevacizumab) followed by liver resection. Synchronous metastases – in 54 patients (53%). Metachronous metastases – in 47 (47%). Bilobate lesion – in 62 patients (62%). Solitary metastasis – in 46 (46%). Multiple metastasis – in 55 (54%). Partial regression of tumor was observed in 26 patients (26%), stabilization – in 53 (53%). Progression – in 21 (21%). Extensive liver resection with resection of contralateral lobe was performed in 39 patients (39%). Standard hepatectomy – in 71 (70%). Extended hepatectomy – in 30 (30%). Extrahepatic metastases – in 23 patients (23%). Metastases in lymph nodes of hepatoduodenal ligament – 18 (18%).

Results

Univariate analysis revealed three unfavorable factors: bilobate lesion of the liver (p = 0.04), multiple liver metastases (p= 0.00029), metastases to the hepatoduodenal ligament (p = 0.001). Multivariate analysis revealed two unfavorable prognostic factors: multiple liver metastases (p = 0.015), metastases to the hepatoduodenal ligament (p = 0.04). Overall survival with FOLFOX 6 + bevacizumab: Median – 33 months, 3-years - 36 ± 10, 5 years - 12 ± 7. With FOLFOX 6: Median – 29 months, 3 years – 42 ± 7, 5 years – 14 ± 6. Overall survival in case of metastases to the lymph nodes of hepatoduodenal ligament. With metastases: Median – 27 months, 3 years – no, 5 years – no. Without metastases: Median – 35 months, 3 years - 49 ± 7, 5 years – 16 ± 6. Overall survival depending on the number of liver foci. Solitary foci: Median – 35 months, 3 years - 42 ± 10, 5 years – 23 ± 10. Multiple foci: Median – 28 months, 3 years – 51 ± 10, 5 years – 12 ± 7.

Conclusion

The main criteria characterizing tumor aggressiveness are the number of liver foci and metastases to the hepatoduodenal ligament, which determine tumor spreading.

Disclosure

All authors have declared no conflicts of interest.