P-267 - Systemic therapy and surgery improve overall survival compared with surgery alone after curative liver resection of colorectal metastases: a single-...

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Anti-Cancer Agents & Biologic Therapy
Colon Cancer
Rectal Cancer
Surgery and/or Radiotherapy of Cancer
Presenter P. Quesada-Soto
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors P. Quesada-Soto1, A. Ramos-Esquivel2, M. Matamoros2, D. Landaverde2
  • 1Centro Nacional de Cirugía Hepatobiliar, San Jose/CR
  • 2Centro Nacional de Cirugía Hepatobiliar, San José/CR

Abstract

Introduction

Resection of liver-isolated metastases of colorectal cancer (CRC) offers the greatest likelihood of cure. Nevertheless, recurrences after this procedure are high and chemotherapy is a reasonable choice with inconclusive evidence. We aimed to determine if there is a survival difference in patients receiving systemic therapy along with surgery versus surgery alone for resection of liver metastases.

Methods

From a source population of 170 patients treated in our national center with liver metastases from various primaries, we selected 51 cases with CRC who achieved hepatic resection with curative intent. We categorized patients according to the treatment received (fluoropyrimidine-based chemotherapy ± monoclonal antibody and surgery versus surgery alone) and then we calculated the overall survival (OS) rate according to the Kaplan-Meier method. A Cox proportional hazard model was used to assess the influence of potential confounding variables on OS.

Results

After a median follow-up of 41.6 months, OS was significantly better for patients treated with systemic therapy (before and/or after hepatic resection) versus surgery alone (3-years OS: 66.7% versus 41.7%; hazard ratio (HR): 0.37; 95% CI: 0.15–0.91; log-rank test: p = 0.025). There were no differences among patients who underwent neoadjuvant (48.7%), perioperative (46.2%), and adjuvant therapy (5.1%) (Log rank test: p = 0.91). The use of systemic therapy was significantly associated with better overall survival after adjustment for confounding variables (HR: 0.23; 95% CI: 0.07-0.92; p = 0.03).

Conclusion

Our findings support the use of systemic therapy (either perioperative, neoadjuvant or adjuvant) as part of isolated hepatic metastases form CRC.

Figure: P-267. Probability of overall survival (Kaplan-Meier Method) according to treatment received (Hazard ratio: 0.37; 95% Confidence Interval: 0.15–0.91; log-rank test: p=0.025