Prognostički parametri kod bolesnika operisanih od metastaza kolorektalnog karcinoma u jetri nakon biološke terapije i hemioterapije

Abstract

The aim of the research was to investigate prognostic factors in patients with resected colorectal liver metastases (CLMs) after biological and chemotherapy, which made initially unresectable disease suitable for resection. Sixty-six patients with resected CLMs, operated after induction bio-chemotherapy with bevacizumab + FOLFOX4, treated at the Clinic of Oncology, Clinical Center Niš from 2010 - 2017 were included. Disease-free survival (DFS) and overall survival (OS) were estimated using the Kaplan-Meier method and compared using the log-rank test according to demographic characteristics, characteristics of the disease and the treatment. A univariate COX regression analysis was performed. In patients with up to 4 CLMs, DFS was significantly longer than in patients with five or more metastases (18,384 v.s. 6,85 months; p < 0,001). Significantly longer OS was present in patients with up to four CLMs than in those with five or more CLMs (44,687 v.s. 29,723 months; p=0,006) and in patients without extrahepatic disease (41,71 v.s. 23,283 months; p=0,012). In the univariate analysis, five or more CLMs were predictors of poorer DFS (HR 3,989; 95% CI 1,055 - 15,087; p = 0,042), whereas the absence of extrahepatic disease was a predictor of better OS (HR 0,122; 95% CI 0,017 - 0,869; p = 0,036). Results of this research are in concordance with previous larger studies in patients with resected CLMs. The number of hepatic and the presence of extrahepatic metastases are prognostic parameters in patients with resected CLM after conversion bio-chemotherapy.