内容紹介
Preoperative Chemotherapy and Risk Factors for Colorectal Liver Metastases
Summary
Between February 2007 and December 2013, 65 liver resections for colorectal metastases were performed in our institution. Preoperative chemotherapy was conducted in 47 patients, of whom 42 were treated with modified FOLFOX6(mFOLFOX6)-based preoperative chemotherapy. For cases of solitary tumors smaller than 2 cm that are located in the liver surface area, we selected upfront surgery. In the patients who underwent preoperative chemotherapy and upfront surgery, the 3-year OS was 73.9%(Grade A: 81.8%, Grade B: 77.8%, and Grade C: 0%)and the 5-year OS was 62.5%. The 3-year OS in the preoperative chemotherapy group was 63.3%. OS did not differ significantly between the patients who were grouped according to the time of metastasis onset or the extent of metastasis according to the Japanese classification. In the multivariate analysis, no statistical differences were found between the risk factors for recurrence. However, further follow up is needed. Moreover, we believe that the relationships of morphological response to chemotherapy, pathological response, and clinical prognosis should be assessed in the future.
要旨
われわれの施設では,以前から大腸癌肝転移に対する治療戦略として術前化学療法を積極的に施行してきた。当科で経験した大腸癌肝転移切除例65例を対象に術前化学療法の安全性と生存・再発,再発のリスク因子に関する検討を行った。65例の治療成績は3年生存率73.9%(Grade A: 81.8%,Grade B: 77.8%,Grade C: 0%),5年生存率は62.5%であった。術前化学療法群での3年生存率は63.3%であった。同時性・異時性肝転移での比較,Grade AとB+Cでの比較で生存率に有意差はなかった。再発のリスクにおいても有意差のある因子を抽出できなかった。今後はさらなる観察期間の延長による検討が必要と考えられた。また,画像上の形態学的評価を行い,ベバシズマブ投与群の57.1%に高度奏効を認めた。形態学的変化と病理学的変化との関連性,臨床的な予後との相関についてさらなる検討が必要と考えられた。
目次
Summary
Between February 2007 and December 2013, 65 liver resections for colorectal metastases were performed in our institution. Preoperative chemotherapy was conducted in 47 patients, of whom 42 were treated with modified FOLFOX6(mFOLFOX6)-based preoperative chemotherapy. For cases of solitary tumors smaller than 2 cm that are located in the liver surface area, we selected upfront surgery. In the patients who underwent preoperative chemotherapy and upfront surgery, the 3-year OS was 73.9%(Grade A: 81.8%, Grade B: 77.8%, and Grade C: 0%)and the 5-year OS was 62.5%. The 3-year OS in the preoperative chemotherapy group was 63.3%. OS did not differ significantly between the patients who were grouped according to the time of metastasis onset or the extent of metastasis according to the Japanese classification. In the multivariate analysis, no statistical differences were found between the risk factors for recurrence. However, further follow up is needed. Moreover, we believe that the relationships of morphological response to chemotherapy, pathological response, and clinical prognosis should be assessed in the future.
要旨
われわれの施設では,以前から大腸癌肝転移に対する治療戦略として術前化学療法を積極的に施行してきた。当科で経験した大腸癌肝転移切除例65例を対象に術前化学療法の安全性と生存・再発,再発のリスク因子に関する検討を行った。65例の治療成績は3年生存率73.9%(Grade A: 81.8%,Grade B: 77.8%,Grade C: 0%),5年生存率は62.5%であった。術前化学療法群での3年生存率は63.3%であった。同時性・異時性肝転移での比較,Grade AとB+Cでの比較で生存率に有意差はなかった。再発のリスクにおいても有意差のある因子を抽出できなかった。今後はさらなる観察期間の延長による検討が必要と考えられた。また,画像上の形態学的評価を行い,ベバシズマブ投与群の57.1%に高度奏効を認めた。形態学的変化と病理学的変化との関連性,臨床的な予後との相関についてさらなる検討が必要と考えられた。