Recurrence after liver resection of colorectal liver metastases: Repeat resection or ablation followed by hepatic arterial infusion pump chemotherapy Journal Article

   

Authors:	Buisman, F. E.; Filipe, W. F.; Kemeny, N. E.; Narayan, R. R.; Srouji, R. M.; Balachandran, V. P.; Boerner, T.; Drebin, J. A.; Jarnagin, W. R.; Kingham, T. P.; Wei, A. C.; Grünhagen, D. J.; Verhoef, C.; Koerkamp, B. G.; D’Angelica, M. I.
Article Title:	Recurrence after liver resection of colorectal liver metastases: Repeat resection or ablation followed by hepatic arterial infusion pump chemotherapy
Abstract:	Background: The aim of this study was to investigate the effectiveness of adjuvant hepatic arterial infusion pump (HAIP) chemotherapy after complete resection or ablation of recurrent colorectal liver metastases (CRLM). Methods: A retrospective cohort study was conducted of patients from two centers who were treated with resection and/or ablation of recurrent CRLM only between 1992 and 2018. Overall survival (OS) and hepatic disease-free survival (hDFS) were estimated using the Kaplan–Meier method. The Cox regression method was used to calculate hazard ratios (HRs) with corresponding 95% confidence intervals (CI). Results: Of 374 eligible patients, 81 (22%) were treated with adjuvant HAIP chemotherapy. The median follow-up for survivors was 65 months (IQR 32–118 months). Patients receiving adjuvant HAIP were more likely to have multifocal disease and receive perioperative systemic chemotherapy at time of resection for recurrence. A median hDFS of 46 months (95% CI 29–81 months) was found in patients treated with adjuvant HAIP compared with 18 months (95% CI 15–26 months) in patients treated with resection and/or ablation alone (p = 0.001). The median OS and 5-year OS were 89 months (95% CI 52–126 months) and 66%, respectively, in patients treated with adjuvant HAIP compared with 57 months (95% CI 47–67 months) and 47%, respectively, in patients treated with resection and/or ablation only (p = 0.002). Adjuvant HAIP was associated with superior hDFS (adjusted HR 0.599, 95% CI 0.38–0.93, p = 0.02) and OS (adjusted HR 0.59, 95% CI 0.38–0.92, p = 0.02) in multivariable analysis. Conclusion: Adjuvant HAIP chemotherapy after resection and/or ablation of recurrent CRLM is associated with superior hDFS and OS. © 2020, The Author(s).
Keywords:	adult; controlled study; treatment outcome; aged; cancer surgery; major clinical study; overall survival; cancer recurrence; adjuvant therapy; comparative study; disease free survival; follow up; antineoplastic agent; cohort analysis; retrospective study; confidence interval; proportional hazards model; adjuvant chemotherapy; liver resection; clinical effectiveness; hazard ratio; kaplan meier method; colorectal liver metastasis; time to treatment; human; male; female; article
Journal Title:	Annals of Surgical Oncology
Volume:	28
Issue:	2
ISSN:	1068-9265
Publisher:	Springer
Date Published:	2021-02-01
Start Page:	808
End Page:	816
Language:	English
DOI:	10.1245/s10434-020-08776-0
PUBMED:	32648182
PROVIDER:	scopus
PMCID:	PMC7801355
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85087727723&doi=10.1245%2fs10434-020-08776-0&partnerID=40&md5=6453d6ceb0ba28fb938e7915be8d5450
Notes:	Article -- Export Date: 1 February 2021 -- Source: Scopus

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