Abstract
BackgroundPathologic response is evaluated according to the extent of tumor regression and is used to estimate the efficacy of preoperative treatment. Several studies have reported the association between the pathologic response and clinical outcomes of colorectal cancer patients with liver metastases who underwent hepatectomy. However, to date, no data from Chinese patients have been reported. In this study, we aimed to evaluate the association between the pathologic response to pre-hepatectomy chemotherapy and prognosis in a cohort of Chinese patients.Patients and methodsIn this retrospective study, we analyzed the data of 380 liver metastases in 159 patients. The pathologic response was evaluated according to the tumor regression grade (TRG). The prognostic role of pathologic response in recurrence-free survival (RFS) and overall survival (OS) was assessed using Kaplan–Meier curves with the log-rank test and multivariate Cox models. Factors that had potential influence on pathologic response were also analyzed using multivariate logistic regression and Kruskal–Wallis/Mann–Whitney U tests.ResultsPatients whose tumors achieved pathologic response after preoperative chemotherapy had significant longer RFS and OS than patients whose tumor had no pathologic response to chemotherapy (median RFS: 9.9 vs. 6.5 months, P = 0.009; median OS: 40.7 vs. 28.1 months, P = 0.040). Multivariate logistic regression and Kruskal–Wallis/Mann–Whitney U tests showed that metastases with small diameter, metastases from the left-side primary tumors, and metastases from patients receiving long-duration chemotherapy had higher pathologic response rates than their control metastases (all P < 0.05). A decrease in the serum carcinoembryonic antigen (CEA) level after preoperative chemotherapy predicted an increased pathologic response rate (P < 0.05). Although the application of targeted therapy did not significantly influence TRG scores of all cases of metastases, the addition of cetuximab to chemotherapy resulted in a higher pathologic response rate when combined with irinotecan-based regimens rather than with oxaliplatin-based regimens.ConclusionsWe found that the evaluation of pathologic response may predict the prognosis of Chinese colorectal cancer patients with liver metastases after preoperative chemotherapy. Small tumor diameter, long-duration chemotherapy, left primary tumor, and decreased serum CEA level after chemotherapy are associated with increased pathologic response rates.
Highlights
Colorectal cancer is the fifth most common cancer and the leading cause of cancer-related death in China, with an increasing incidence of 4%–6% annually [1,2,3,4]
We found that the evaluation of pathologic response may predict the prognosis of Chinese colo‐ rectal cancer patients with liver metastases after preoperative chemotherapy
Long-duration chemotherapy, left primary tumor, and decreased serum carcinoembryonic antigen (CEA) level after chemotherapy are associated with increased pathologic response rates
Summary
Colorectal cancer is the fifth most common cancer and the leading cause of cancer-related death in China, with an increasing incidence of 4%–6% annually [1,2,3,4]. Prolonged survival is not always associated with radiologic response, especially when targeted therapy agents are added to the chemotherapy regimen [15]. Pathologic response is another evaluation index that could be used to evaluate the efficacy of preoperative chemotherapy. The pathologic response of colorectal cancer patients with liver metastases is generally evaluated according to the tumor regression grade (TRG) [16]. Several studies have reported the association between the pathologic response and clinical outcomes of colorectal cancer patients with liver metastases who underwent hepatectomy. We aimed to evaluate the asso‐ ciation between the pathologic response to pre-hepatectomy chemotherapy and prognosis in a cohort of Chinese patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
