Predictive Factors for the Survival Outcomes of Preoperative Chemotherapy in Patients with Resectable and Borderline Resectable Colorectal Cancer with Liver Metastasis
Issued Date
2023-01-01
Resource Type
ISSN
15137368
eISSN
2476762X
Scopus ID
2-s2.0-85173440826
Journal Title
Asian Pacific Journal of Cancer Prevention
Volume
24
Issue
9
Start Page
3037
End Page
3047
Rights Holder(s)
SCOPUS
Bibliographic Citation
Asian Pacific Journal of Cancer Prevention Vol.24 No.9 (2023) , 3037-3047
Suggested Citation
Inworn N., Senavat P., Aleenajitpong N., Chingchaimaneesri M., Siripoon T., Srirattanapong S., Suragul W., Ngamphaiboon N. Predictive Factors for the Survival Outcomes of Preoperative Chemotherapy in Patients with Resectable and Borderline Resectable Colorectal Cancer with Liver Metastasis. Asian Pacific Journal of Cancer Prevention Vol.24 No.9 (2023) , 3037-3047. 3047. doi:10.31557/APJCP.2023.24.9.3037 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/90579
Title
Predictive Factors for the Survival Outcomes of Preoperative Chemotherapy in Patients with Resectable and Borderline Resectable Colorectal Cancer with Liver Metastasis
Author's Affiliation
Other Contributor(s)
Abstract
Background: Preoperative chemotherapy increases resectability in borderline resectable colorectal liver metastasis (CRLM) patients who undergo curative liver surgery. Most clinical risk scores and other predictive factors for survival have been extensively studied in patients who undergo upfront liver surgery. However, predictive factors of CRLM patients who received preoperative chemotherapy remains controversial. Methods: CRLM patients who received preoperative systemic therapy followed by curative liver surgery at our institution between 1/2012 and 12/2018 were included. This study aimed to investigate factors that predicted the outcomes of preoperative systemic treatment, optimal dose/duration, and toxicity in patients with CRLM. Outcomes: Ninety-eight patients were eligible for analysis. Most patients received oxaliplatin-based chemotherapy (72.7%), while 15.9% received both oxaliplatin and irinotecan. Biologic agents were administered in 48.9% of patients. Overall, chemotherapy-induced liver injury was observed in 38.5%. The median disease-free survival (DFS) and overall survival (OS) were 8.7 months and 3.6 years, respectively. Baseline, pre-surgery, and increased Fong scores after preoperative chemotherapy were significantly associated with DFS and OS. In multivariate analysis, a high Fong score at baseline (p=0.018) was significantly associated with shorter DFS, whereas male sex (p=0.040) and liver surgery (p=0.044) were related to longer OS. Conclusion: In our study, Fong clinical risk scores, female sex, and liver surgery as a part of liver-directed therapy were independent prognostic factors for survival in CRLM patients who received preoperative chemotherapy. These clinical factors should be considered as an option to guide physicians’ decisions in selecting patients with CRLM who may benefit most from curative liver-directed therapy.