Detailed Abstract
[Liver Oral Presentation 2 - Liver (Liver Disease/Surgery)]
[LV OP 2-S3] Outcome of Initially Unresectable Colorectal Liver Metastases: Optimization of Conversion Surgery And Outcome after Recurrence.
Kosuke KOBAYASHI 1, Yosuke INOUE 1, Atsushi OBA 1, Yoshihiro ONO 1, Takafumi SATO 1, Hiromichi ITO 1, Yu TAKAHASHI 1
1 Division of Hepatobiliary And Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, JAPAN
Background : We evaluated long-term outcomes for unresectable colorectal liver metastases (CLM), focusing on conversion surgery (CS), predictive models, recurrence patterns, and subsequent treatments.
Methods : This retrospective study at Cancer Institute Hospital of the Japanese Foundation for Cancer Research in Tokyo analyzed consecutive patients who underwent initial liver resection from 2014 to 2020.
Results : Initially, out of 122 patients who were diagnosed with technically unresectable CLMs and received induction chemotherapy, 61 underwent CS (CS group), while the others did not (Non-CS group). The median overall survival (OS) for the CS group was 5.6 years, markedly surpassing the Non-CS group's 1.8 years (p〈 0.001). A scoring model predicting CS was devised from four factors by multivariable analyses —RAS status, number of tumors, contact with hepatic veins, and presence of preservable section—with an impressive 0.870 area under the curve for CS. An analysis in resection cohort showed no significant difference between unresectable and borderline resectable (BR) CLMs in terms of recurrence rate (88% vs. 81%, p=0.117), pattern (intra-, extrahepatic, or both; 38%, 32%, 30% vs. 36%, 39%, 25%, p=0.492), and repeat resection rate (47% vs. 46%, p=0.858). MST after repeat resection was comparable in both groups (3.1-year vs. 2.8-year, p=0.981).
Conclusions : CS offers a significantly improved prognosis for unresectable CLMs which is comparable to BR CLMs. It is crucial to identify all potential candidates for CS, and our predictive model proves to be a valuable tool in anticipating CS eligibility and outcomes.
Methods : This retrospective study at Cancer Institute Hospital of the Japanese Foundation for Cancer Research in Tokyo analyzed consecutive patients who underwent initial liver resection from 2014 to 2020.
Results : Initially, out of 122 patients who were diagnosed with technically unresectable CLMs and received induction chemotherapy, 61 underwent CS (CS group), while the others did not (Non-CS group). The median overall survival (OS) for the CS group was 5.6 years, markedly surpassing the Non-CS group's 1.8 years (p〈 0.001). A scoring model predicting CS was devised from four factors by multivariable analyses —RAS status, number of tumors, contact with hepatic veins, and presence of preservable section—with an impressive 0.870 area under the curve for CS. An analysis in resection cohort showed no significant difference between unresectable and borderline resectable (BR) CLMs in terms of recurrence rate (88% vs. 81%, p=0.117), pattern (intra-, extrahepatic, or both; 38%, 32%, 30% vs. 36%, 39%, 25%, p=0.492), and repeat resection rate (47% vs. 46%, p=0.858). MST after repeat resection was comparable in both groups (3.1-year vs. 2.8-year, p=0.981).
Conclusions : CS offers a significantly improved prognosis for unresectable CLMs which is comparable to BR CLMs. It is crucial to identify all potential candidates for CS, and our predictive model proves to be a valuable tool in anticipating CS eligibility and outcomes.
SESSION
Liver Oral Presentation 2
Room F 3/22/2024 4:30 PM - 5:30 PM