Impact of homogeneous pathologic response to preoperative chemotherapy in patients with multiple colorectal liver metastases

World J Gastroenterol. 2017 Dec 7;23(45):8027-8034. doi: 10.3748/wjg.v23.i45.8027.

Abstract

Aim: To analyze the homogeneity of pathologic response to preoperative chemotherapy (PRPC) after chemotherapy in patients with multiple liver metastases (LM).

Methods: From September 2011 to August 2014, patients with at least two LM undergoing preoperative chemotherapy prior to resection were included in this retrospective, single-center study. The endpoints were PRPC homogeneity (according to both the Rubbia-Brandt and MD Anderson classifications), the impact of PRPC on the MDT decision, factors associated with homogeneous PRPC and overall survival of patients with vs. without homogeneous PRPC.

Results: seventy-three patients with a total of 88 liver resections (including 15 two-stage procedures) were included in the study. The homogeneous PRPC rate was 55% according to the Rubbia-Brandt classification and 53% according to the MD Anderson classification. The MDT decision was modified by the PRPC in only 2.7% of patients (n = 2).

Conclusion: The PRPC was homogeneous in only one half of patients and had very little influence on the MDT decision.

Keywords: Colorectal cancer; Homogeneity; Liver metastases; Pathological response; Preoperative chemotherapy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Clinical Decision-Making / methods
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / therapy*
  • Female
  • Hepatectomy
  • Humans
  • Liver / surgery
  • Liver Neoplasms / mortality
  • Liver Neoplasms / secondary
  • Liver Neoplasms / therapy*
  • Male
  • Middle Aged
  • Neoadjuvant Therapy / methods*
  • Patient Care Team
  • Response Evaluation Criteria in Solid Tumors
  • Retrospective Studies
  • Survival Rate