Improved Survival over Time After Resection of Colorectal Liver Metastases and Clinical Impact of Multigene Alteration Testing in Patients with Metastatic Colorectal Cancer

Background The past 20 years have seen advances in colorectal cancer management. We sought to determine whether survival in patients undergoing resection of colorectal liver metastases (CLM) has improved in association with three landmark advances: introduction of irinotecan- and/or oxaliplatin-cont...

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Published in:Journal of gastrointestinal surgery 2022-03, Vol.26 (3), p.583-593
Main Authors: Kawaguchi, Yoshikuni, Kopetz, Scott, Panettieri, Elena, Hwang, Hyunsoo, Wang, Xuemei, Cao, Hop S. Tran, Tzeng, Ching-Wei D., Chun, Yun Shin, Aloia, Thomas A., Vauthey, Jean-Nicolas
Format: Article
Language:English
Subjects:
Antineoplastic Combined Chemotherapy Protocols
Cancer therapies
Chemotherapy
Colonic Neoplasms - surgery
Colorectal cancer
Colorectal Neoplasms - pathology
Epidermal growth factor
Gastroenterology
Gastrointestinal surgery
Hepatectomy
Humans
Irinotecan - therapeutic use
Laboratories
Liver
Liver Neoplasms - drug therapy
Liver Neoplasms - genetics
Liver Neoplasms - surgery
Medical prognosis
Medicine
Medicine & Public Health
Metastasis
Mutation
Original Article
Oxaliplatin - therapeutic use
Prognosis
Rectal Neoplasms - surgery
Statistical analysis
Surgery
Surgical outcomes
Survival Rate
Trends
Vascular endothelial growth factor
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Summary:Background The past 20 years have seen advances in colorectal cancer management. We sought to determine whether survival in patients undergoing resection of colorectal liver metastases (CLM) has improved in association with three landmark advances: introduction of irinotecan- and/or oxaliplatin-containing regimens, molecular targeted therapy, and multigene alteration testing. Methods Patients undergoing CLM resection during 1998–2014 were identified and grouped by resection year. The influence of alterations in RAS , TP53 , and SMAD4 was evaluated and validated in an external cohort including patients with unresectable metastatic colorectal cancer. Results Of 1961 patients, 1599 met the inclusion criteria. Irinotecan- and/or oxaliplatin-containing regimens and molecular targeted therapy were used for more than 50% of patients starting in 2001 and starting in 2006, respectively, so patients were grouped as undergoing resection during 1998–2000, 2001–2005, or 2006–2014. Liver resectability indications expanded over time. The 5-year overall survival (OS) rate was significantly better in 2006–2014, vs. 2001–2005 (56.5% vs. 44.1%, P  
ISSN:1091-255X
1873-4626
DOI:10.1007/s11605-021-05110-1