Progression while receiving preoperative chemotherapy should not be an absolute contraindication to liver resection for colorectal metastases

Luca Viganó, Lorenzo Capussotti, Eduardo Barroso, Gennaro Nuzzo, Christophe Laurent, Jan N M Ijzermans, Jean François Gigot, Joan Figueras, Thomas Gruenberger, Darius F. Mirza, Dominique Elias, Graeme Poston, Christian Letoublon, Helena Isoniemi, Javier Herrera, Francisco Castro Sousa, Fernando Pardo, Valerio Lucidi, Irinel Popescu, René Adam

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Purpose: Tumor progression while receiving neoadjuvant chemotherapy (PD) has been associated with poor outcome and is commonly considered a contraindication to liver resection (LR). This study aims to clarify in a large multicenter setting whether PD is always a contraindication to LR. Methods: Data from the LiverMetSurvey international registry were analyzed. Patients undergoing LR for colorectal metastases without extrahepatic disease after neoadjuvant chemotherapy between 1990 and 2009 were reviewed. Results: Among 2143 patients, PD occurred in 176 (8.2 %). Risk of progression was increased after 5-FU or irinotecan (22.7 % vs. 6.8 % after other regimens, p<0.0001;14.9 % vs. 7.2 %, p<0.0001), while it was reduced after oxaliplatin (5.6 % vs. 12.0 %, p 3 metastases (p = 0.028), and tumor diameter ≥50 mm (p = 0.002). A survival predictive model showed that patients without any risk factors had 5-year survival rates of 53.3 %; good survival results were still observed if metastases were>3 or ≥50 mm (29.9 and 19.1 %, respectively). On the contrary, survival was less than 10 % at 3 years in the presence of>1 prognostic factor or CEA of ≥200 ng/mL. Conclusions: PD is a negative prognostic factor, but it is not an absolute contraindication to LR. Patients with PD could be scheduled for LR except for those with >3 metastases and ≥50 mm, or CEA ≥200 ng/mL in whom further chemotherapy is recommended.

Original languageEnglish
Pages (from-to)2786-2796
Number of pages11
JournalAnnals of Surgical Oncology
Volume19
Issue number9
DOIs
Publication statusPublished - Sep 2012

Fingerprint

Neoplasm Metastasis
Drug Therapy
Liver
irinotecan
Fluorouracil
Registries
Survival
Neoplasms

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Progression while receiving preoperative chemotherapy should not be an absolute contraindication to liver resection for colorectal metastases. / Viganó, Luca; Capussotti, Lorenzo; Barroso, Eduardo; Nuzzo, Gennaro; Laurent, Christophe; Ijzermans, Jan N M; Gigot, Jean François; Figueras, Joan; Gruenberger, Thomas; Mirza, Darius F.; Elias, Dominique; Poston, Graeme; Letoublon, Christian; Isoniemi, Helena; Herrera, Javier; Sousa, Francisco Castro; Pardo, Fernando; Lucidi, Valerio; Popescu, Irinel; Adam, René.

In: Annals of Surgical Oncology, Vol. 19, No. 9, 09.2012, p. 2786-2796.

Research output: Contribution to journalArticle

Viganó, L, Capussotti, L, Barroso, E, Nuzzo, G, Laurent, C, Ijzermans, JNM, Gigot, JF, Figueras, J, Gruenberger, T, Mirza, DF, Elias, D, Poston, G, Letoublon, C, Isoniemi, H, Herrera, J, Sousa, FC, Pardo, F, Lucidi, V, Popescu, I & Adam, R 2012, 'Progression while receiving preoperative chemotherapy should not be an absolute contraindication to liver resection for colorectal metastases', Annals of Surgical Oncology, vol. 19, no. 9, pp. 2786-2796. https://doi.org/10.1245/s10434-012-2382-7
Viganó, Luca ; Capussotti, Lorenzo ; Barroso, Eduardo ; Nuzzo, Gennaro ; Laurent, Christophe ; Ijzermans, Jan N M ; Gigot, Jean François ; Figueras, Joan ; Gruenberger, Thomas ; Mirza, Darius F. ; Elias, Dominique ; Poston, Graeme ; Letoublon, Christian ; Isoniemi, Helena ; Herrera, Javier ; Sousa, Francisco Castro ; Pardo, Fernando ; Lucidi, Valerio ; Popescu, Irinel ; Adam, René. / Progression while receiving preoperative chemotherapy should not be an absolute contraindication to liver resection for colorectal metastases. In: Annals of Surgical Oncology. 2012 ; Vol. 19, No. 9. pp. 2786-2796.
@article{88e252be6d52480fbac96b1007a741ee,
title = "Progression while receiving preoperative chemotherapy should not be an absolute contraindication to liver resection for colorectal metastases",
abstract = "Purpose: Tumor progression while receiving neoadjuvant chemotherapy (PD) has been associated with poor outcome and is commonly considered a contraindication to liver resection (LR). This study aims to clarify in a large multicenter setting whether PD is always a contraindication to LR. Methods: Data from the LiverMetSurvey international registry were analyzed. Patients undergoing LR for colorectal metastases without extrahepatic disease after neoadjuvant chemotherapy between 1990 and 2009 were reviewed. Results: Among 2143 patients, PD occurred in 176 (8.2 {\%}). Risk of progression was increased after 5-FU or irinotecan (22.7 {\%} vs. 6.8 {\%} after other regimens, p<0.0001;14.9 {\%} vs. 7.2 {\%}, p<0.0001), while it was reduced after oxaliplatin (5.6 {\%} vs. 12.0 {\%}, p 3 metastases (p = 0.028), and tumor diameter ≥50 mm (p = 0.002). A survival predictive model showed that patients without any risk factors had 5-year survival rates of 53.3 {\%}; good survival results were still observed if metastases were>3 or ≥50 mm (29.9 and 19.1 {\%}, respectively). On the contrary, survival was less than 10 {\%} at 3 years in the presence of>1 prognostic factor or CEA of ≥200 ng/mL. Conclusions: PD is a negative prognostic factor, but it is not an absolute contraindication to LR. Patients with PD could be scheduled for LR except for those with >3 metastases and ≥50 mm, or CEA ≥200 ng/mL in whom further chemotherapy is recommended.",
author = "Luca Vigan{\'o} and Lorenzo Capussotti and Eduardo Barroso and Gennaro Nuzzo and Christophe Laurent and Ijzermans, {Jan N M} and Gigot, {Jean Fran{\cc}ois} and Joan Figueras and Thomas Gruenberger and Mirza, {Darius F.} and Dominique Elias and Graeme Poston and Christian Letoublon and Helena Isoniemi and Javier Herrera and Sousa, {Francisco Castro} and Fernando Pardo and Valerio Lucidi and Irinel Popescu and Ren{\'e} Adam",
year = "2012",
month = "9",
doi = "10.1245/s10434-012-2382-7",
language = "English",
volume = "19",
pages = "2786--2796",
journal = "Annals of Surgical Oncology",
issn = "1068-9265",
publisher = "Springer New York LLC",
number = "9",

}

TY - JOUR

T1 - Progression while receiving preoperative chemotherapy should not be an absolute contraindication to liver resection for colorectal metastases

AU - Viganó, Luca

AU - Capussotti, Lorenzo

AU - Barroso, Eduardo

AU - Nuzzo, Gennaro

AU - Laurent, Christophe

AU - Ijzermans, Jan N M

AU - Gigot, Jean François

AU - Figueras, Joan

AU - Gruenberger, Thomas

AU - Mirza, Darius F.

AU - Elias, Dominique

AU - Poston, Graeme

AU - Letoublon, Christian

AU - Isoniemi, Helena

AU - Herrera, Javier

AU - Sousa, Francisco Castro

AU - Pardo, Fernando

AU - Lucidi, Valerio

AU - Popescu, Irinel

AU - Adam, René

PY - 2012/9

Y1 - 2012/9

N2 - Purpose: Tumor progression while receiving neoadjuvant chemotherapy (PD) has been associated with poor outcome and is commonly considered a contraindication to liver resection (LR). This study aims to clarify in a large multicenter setting whether PD is always a contraindication to LR. Methods: Data from the LiverMetSurvey international registry were analyzed. Patients undergoing LR for colorectal metastases without extrahepatic disease after neoadjuvant chemotherapy between 1990 and 2009 were reviewed. Results: Among 2143 patients, PD occurred in 176 (8.2 %). Risk of progression was increased after 5-FU or irinotecan (22.7 % vs. 6.8 % after other regimens, p<0.0001;14.9 % vs. 7.2 %, p<0.0001), while it was reduced after oxaliplatin (5.6 % vs. 12.0 %, p 3 metastases (p = 0.028), and tumor diameter ≥50 mm (p = 0.002). A survival predictive model showed that patients without any risk factors had 5-year survival rates of 53.3 %; good survival results were still observed if metastases were>3 or ≥50 mm (29.9 and 19.1 %, respectively). On the contrary, survival was less than 10 % at 3 years in the presence of>1 prognostic factor or CEA of ≥200 ng/mL. Conclusions: PD is a negative prognostic factor, but it is not an absolute contraindication to LR. Patients with PD could be scheduled for LR except for those with >3 metastases and ≥50 mm, or CEA ≥200 ng/mL in whom further chemotherapy is recommended.

AB - Purpose: Tumor progression while receiving neoadjuvant chemotherapy (PD) has been associated with poor outcome and is commonly considered a contraindication to liver resection (LR). This study aims to clarify in a large multicenter setting whether PD is always a contraindication to LR. Methods: Data from the LiverMetSurvey international registry were analyzed. Patients undergoing LR for colorectal metastases without extrahepatic disease after neoadjuvant chemotherapy between 1990 and 2009 were reviewed. Results: Among 2143 patients, PD occurred in 176 (8.2 %). Risk of progression was increased after 5-FU or irinotecan (22.7 % vs. 6.8 % after other regimens, p<0.0001;14.9 % vs. 7.2 %, p<0.0001), while it was reduced after oxaliplatin (5.6 % vs. 12.0 %, p 3 metastases (p = 0.028), and tumor diameter ≥50 mm (p = 0.002). A survival predictive model showed that patients without any risk factors had 5-year survival rates of 53.3 %; good survival results were still observed if metastases were>3 or ≥50 mm (29.9 and 19.1 %, respectively). On the contrary, survival was less than 10 % at 3 years in the presence of>1 prognostic factor or CEA of ≥200 ng/mL. Conclusions: PD is a negative prognostic factor, but it is not an absolute contraindication to LR. Patients with PD could be scheduled for LR except for those with >3 metastases and ≥50 mm, or CEA ≥200 ng/mL in whom further chemotherapy is recommended.

UR - http://www.scopus.com/inward/record.url?scp=84867388810&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84867388810&partnerID=8YFLogxK

U2 - 10.1245/s10434-012-2382-7

DO - 10.1245/s10434-012-2382-7

M3 - Article

C2 - 22622469

AN - SCOPUS:84867388810

VL - 19

SP - 2786

EP - 2796

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

IS - 9

ER -