Abstract 2688
Background
Liver resection is a curative treatment for patients with colorectal liver metastasis (CRLM). However, about 70% patients will experience recurrence after resection. CRLM number and maximum (CRLMmax) size have been associated with recurrence after hepatic resection. Still, association between CRLM minimum (CRLMmin) size and tumor recurrence has never been evaluated. This study aimed to correlate CRLMmin on the liver specimen with recurrence free survival (RFS).
Methods
We retrospectively included all patients who underwent first laparoscopic liver resection for CRLM from January 2000 to November 2018 in a single institution. Patients with extra hepatic evolutive disease were excluded. A CRLMmin cut off was selected using the time-dependent area under the curve (td-AUC) for 1 and 2-year RFS. Cox uni and multivariate models were constructed. Multivariate analysis was completed for factors with a p value ≤ 0.10 upon univariate analysis, or previously known determinant factors. Primary end point was RFS.
Results
Overall, 227 patients were included. Median follow- up was 50 months (6-210), 151 (67%) patients presented with recurrence. The optimal CRLMmin cutoff associated with RFS was 9mm (12 and 24-months td-AUC = 0.56 and 0.52, respectively). Median RFS were respectively 11.9 months (CI 95% 7.1-18.7) in patients with CRLMmin size <9mm and 21.9 months (CI 95% 18.5-30.8) for those with CRLMmin size ≥9mm (p < 0.001). In multivariate analysis, CRLMmin size <9mm was an independent prognostic factor for RFS after adjusting on node-positive primary tumor, preoperative carcinoembryonic antigen ACE ≥5ng/ml, multiple liver metastasis and synchronous or metachronous <12months liver metastasis (HR = 1.6 (1.1-2.4); p < 0.05). Also, CRLMmin size <9mm was independently associated with hepatic RFS (HR = 1.8 (1.2-3,0); p < 0.05) but not extra-hepatic RFS.
Conclusions
The present study suggests that CRLMmin size <9mm on the liver specimen was an independent progonostic factor for worse RFS, particularly associated with poor local control over distant metastasis control.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
David Fuks.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
5063 - Does Nutritional Status Affect Treatment Tolarability, Response and Survival in Metastatic Gastric Cancer Patients? Results of Prospective Multicenter Study
Presenter: Senem Karabulut
Session: Poster Display session 2
Resources:
Abstract
2717 - Ramucirumab use in patients with Advanced Gastric Cancer (AGC) or gastro-oesophageal junction (GEJ) adenocarcinoma in Spain: RAMIS observational study
Presenter: Federico Longo Munoz
Session: Poster Display session 2
Resources:
Abstract
3187 - Gastrectomy plus chemotherapy versus chemotherapy alone for advanced gastric cancer with a single non-curable factor: Exploratory analysis in the patients who were enrolled in JCOG0705/KGCA01 phase III trial (REGATTA) and could continue chemotherapy
Presenter: Takaki Yoshikawa
Session: Poster Display session 2
Resources:
Abstract
4765 - A prospective observational study on the optimal maintenance strategy in HER2-positive advanced gastric cancer treated with trastuzumab based therapy
Presenter: Qian Li
Session: Poster Display session 2
Resources:
Abstract
3500 - Randomised phase 2 trial of first-line docetaxel, carboplatin, capecitabine (CTX) and epirubicin, oxaliplatin, capecitabine (EOX) in advanced esophagogastric adenocarcinoma (SEED)
Presenter: Peter Petersen
Session: Poster Display session 2
Resources:
Abstract
5197 - Ramucirumab in the treatment of refractory metastatic gastric cancer: results from the RamSelGa trial.
Presenter: Alexey Tryakin
Session: Poster Display session 2
Resources:
Abstract
2011 - Regorafenib in combination with Paclitaxel for beyond first-line treatment of advanced esophagogastric cancer (REPEAT): a phase Ib trial with expansion cohort
Presenter: Mohammed Khurshed
Session: Poster Display session 2
Resources:
Abstract
2117 - The relationship between the survival and fixed dosing of S-1 in advanced gastric cancer patients by pooled analysis using individual data from four Japanese randomized phase III trials
Presenter: Wataru Ichikawa
Session: Poster Display session 2
Resources:
Abstract
2669 - A Phase 1b Study of Oraxol in Combination with Ramucirumab in Patients with Gastric or Esophageal Cancers who failed previous chemotherapy
Presenter: Ming Huang Chen
Session: Poster Display session 2
Resources:
Abstract
3240 - Efficacy and safety of trifluridine/tipiracil (FTD/TPI) in European patients with heavily pretreated metastatic gastric cancer (mGC): an analysis of the TAGS study
Presenter: Maria Alsina
Session: Poster Display session 2
Resources:
Abstract