Analysis on clinical factors of initial unresectable colorectal cancer with liver metastases converted for re-section
PAN Jun
QIN Shukui
CHEN Yingxia
HUANG Yong
FANG Rong
LI Hui
HAO Liping
HUANG Wei
Abstract：Objective To explore the factors of conversional patients accepted resection who initial were considered as unresectable. Methods From January 2012 to January 2018, 62 patients with synchronous colorectal liver metastases were analyzed. They were divided into resectable group (32 cases) and initial unresectable group (30 cases). Thirty patients who were initially unresectable underwent first-line chemotherapy, including FOLFOX6, XELOX and FOLFIRI combined with cetuximab. The efficacy and safety were evaluated by RECIST 1. 1 and NCI-CTC 4. 0 criteria. Survival analysis were performed by Kaplan-Meier and Log-rank method.Results The efficacy and adverse reactions were evaluated in 30 initial unresectable patients, of which 10 were converted into resectable cases after induction chemotherapy. A total of 187 cycles of chemotherapy were completed, with a median of 5 cycles (3-14 cycles). PR was achieved in 7 cases, SD in 17 cases and PD in 6 cases. The median overall survive (OS) of initial unresectable and resectable patients were 15. 9 months and 26. 4 months (P = 0. 007). The median OS of 10 patients converted into resectable and 20 patients failed to convert were 25. 5 months and 12. 5 months (P = 0. 017). In Univariate analysis, the low conversion rate with diameter of tumor ≥8 cm and high conversion rate with ＜ 8 cm were observed (P ＜ 0. 001). The low conversion rate with number of lesions ≥5 and high conversion rate with ＜ 5 were observed (P = 0. 007). The low conversion rate without anemia and high conversion rate with anemia were observed (P = 0. 004). The major treatment-related side effects including leucopenia, neutropenia, anemia, fatigue, nausea and etc, were mainly in grade 1-2. Conclusion Induction chemotherapy and targeted therapy could be actively adopted to convert the initial unresectable colorectal cancer into resectable cases. The longest diameter of liver metastasis, the number of liver metastasis and anemia may be the key to conversion.
Keywords：Colorectal cancerSynchronous colorectal liver metastasesInitial unresectableInduction chemotherapyConversion therapy
Publication Date：2019-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 44-48 )