Impact of primary tumor laterality on adjuvant hepatic artery infusion pump chemotherapy in resected colon cancer liver metastases: Analysis of 487 patients Journal Article

Authors: Gholami, S.; Stewart, S.; Kemeny, N.; Gönen, M.; Groot Koerkamp, B.; Cercek, A.; Kingham, P.; Balachandran, V.; Allen, P.; DeMatteo, R.; Wei, A.; Connell, L.; Drebin, J.; Jarnagin, W.; D’Angelica, M.
Article Title: Impact of primary tumor laterality on adjuvant hepatic artery infusion pump chemotherapy in resected colon cancer liver metastases: Analysis of 487 patients
Abstract: Background: Hepatic artery infusion (HAI) chemotherapy is associated with overall survival (OS) in patients with resected colon cancer liver metastases (CLM). The prognostic impact of primary tumor location in CLM following hepatic resection in patients receiving regional HAI is unknown. This study seeks to investigate the prognostic impact of HAI in relation to laterality in this patient population. Methods: Consecutive patients with resected CLM, with known primary tumor site treated with and without HAI, were reviewed from a prospective institutional database. Correlations between HAI, laterality, other clinicopathological factors, and survival were analyzed, and Cox proportional hazard regression was used to determine whether laterality was an independent prognostic factor. Results: From 1993 to 2012, 487 patients [182 with right colon cancer (RCC), 305 with left colon cancer (LCC)] were evaluated with a median follow-up of 6.5 years. Fifty-seven percent (n = 275) received adjuvant HAI. Patients with RCC had inferior 5-year OS compared with LCC (56% vs. 67%, P = 0.01). HAI was associated with improved 5-year OS in both RCC (68% vs. 45%; P < 0.01) and LCC (73% vs. 55%; P < 0.01). On multivariable analysis, HAI remained associated with improved OS (HR 0.52; 95% CI 0.39–0.70; P < 0.01) but primary tumor site did not (HR 0.83; 95% CI 0.63–1.11; P = 0.21). Additional significant prognostic factors on multivariable analysis included age, number of tumors, node-positive primary, positive margins, RAS mutation, two-stage hepatectomy, and extrahepatic disease. Cox proportional hazard regression determined no significant interaction between HAI and laterality on OS [parameter estimate (SEM), 0.12 (0.28); P = 0.67]. Conclusions: Our data show an association of adjuvant HAI and increased OS in patients who underwent curative hepatectomy, irrespective of primary tumor location. Laterality should therefore not impact decision-making when offering adjuvant HAI. © 2020, Society of Surgical Oncology.
Keywords: adult; cancer survival; aged; cancer surgery; primary tumor; survival rate; gene mutation; major clinical study; cancer combination chemotherapy; systemic therapy; liver neoplasms; cancer patient; chemotherapy, adjuvant; follow up; prospective study; prospective studies; tumor localization; colonic neoplasms; cohort analysis; dexamethasone; data base; colorectal neoplasms; liver metastasis; colorectal tumor; colon cancer; adjuvant chemotherapy; colon tumor; liver tumor; intraarterial drug administration; infusions, intra-arterial; liver resection; hepatectomy; ras protein; hemispheric dominance; floxuridine; sodium chloride; hepatic artery; surgical margin; heparinization; cancer prognosis; humans; human; male; female; article; adjuvant hepatic artery infusion chemotherapy; tumor number
Journal Title: Annals of Surgical Oncology
Volume: 28
Issue: 7
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2021-07-01
Start Page: 3685
End Page: 3694
Language: English
DOI: 10.1245/s10434-020-09369-7
PUBMED: 33230748
PROVIDER: scopus
PMCID: PMC8385634
Notes: Article -- Export Date: 1 July 2021 -- Source: Scopus
Citation Impact
MSK Authors
  1. Ronald P DeMatteo
    636 DeMatteo
  2. Mithat Gonen
    885 Gonen
  3. Peter Allen
    499 Allen
  4. William R Jarnagin
    741 Jarnagin
  5. T Peter Kingham
    430 Kingham
  6. Nancy Kemeny
    507 Kemeny
  7. Louise Catherine Connell
    31 Connell
  8. Jeffrey Adam Drebin
    80 Drebin
  9. Alice Chia-Chi Wei
    55 Wei