Efficacy of upfront hepatectomy without neoadjuvant chemotherapy for resectable colorectal liver metastasis
Abstract Background Hepatectomy for resectable colorectal liver metastasis (CRLM) is recommended. However, the efficacy of upfront hepatectomy without neoadjuvant chemotherapy (NAC) is unclear due to the uncertainty of perioperative systemic chemotherapy. Moreover, it is crucial to predict the progn...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-04-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-021-02210-9 |
| _version_ | 1831637430251290624 |
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| author | Kosuke Ono Tomoyuki Abe Akihiko Oshita Yusuke Sumi Takuya Yano Hiroshi Okuda Manabu Kurayoshi Tsuyoshi Kobayashi Hideki Ohdan Toshio Noriyuki Masahiro Nakahara |
| author_facet | Kosuke Ono Tomoyuki Abe Akihiko Oshita Yusuke Sumi Takuya Yano Hiroshi Okuda Manabu Kurayoshi Tsuyoshi Kobayashi Hideki Ohdan Toshio Noriyuki Masahiro Nakahara |
| author_sort | Kosuke Ono |
| collection | DOAJ |
| description | Abstract Background Hepatectomy for resectable colorectal liver metastasis (CRLM) is recommended. However, the efficacy of upfront hepatectomy without neoadjuvant chemotherapy (NAC) is unclear due to the uncertainty of perioperative systemic chemotherapy. Moreover, it is crucial to predict the prognosis when considering perioperative chemotherapy. This study evaluated the impact of neoadjuvant chemotherapy on the prognosis of patients with resectable CRLM and assessed the usefulness of Beppu’s nomogram for predicting prognosis. Methods This retrospective study identified 88 consecutive inpatients who underwent primary hepatic resection for CRLM; 58 received neoadjuvant chemotherapy and 30 underwent upfront surgery. Factors associated with recurrence-free survival were identified via univariate and multivariate analysis. Furthermore, propensity score analysis using inverse probability of treatment weighting (IPTW) was performed. Results On univariate analysis, poor recurrence-free survival was associated with multiple tumors, advanced primary tumor stage, vascular invasion by the primary tumor, a Beppu’s nomogram score ≥ 6, and neoadjuvant chemotherapy. On multivariate analysis, a Beppu’s nomogram score ≥ 6 and neoadjuvant chemotherapy were independent risk factors for recurrence. Neoadjuvant chemotherapy recipients had a higher incidence of lymph node metastasis and vascular invasion than non-recipients. Propensity score analysis revealed no significant difference in the recurrence-free survival rate between these groups. Conclusions Our results show that upfront hepatectomy without neoadjuvant chemotherapy can be considered for resectable CRLM treatment. Beppu’s nomogram score can be a tool for predicting the prognosis of patients with CRLM. |
| first_indexed | 2024-12-19T06:52:09Z |
| format | Article |
| id | doaj.art-4ae0df3041a240abb63d07fb62016f6f |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-12-19T06:52:09Z |
| publishDate | 2021-04-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-4ae0df3041a240abb63d07fb62016f6f2022-12-21T20:31:41ZengBMCWorld Journal of Surgical Oncology1477-78192021-04-011911810.1186/s12957-021-02210-9Efficacy of upfront hepatectomy without neoadjuvant chemotherapy for resectable colorectal liver metastasisKosuke Ono0Tomoyuki Abe1Akihiko Oshita2Yusuke Sumi3Takuya Yano4Hiroshi Okuda5Manabu Kurayoshi6Tsuyoshi Kobayashi7Hideki Ohdan8Toshio Noriyuki9Masahiro Nakahara10Department of Surgery, Onomichi General HospitalDepartment of Surgery, Onomichi General HospitalDepartment of Surgery, Onomichi General HospitalDepartment of Surgery, Onomichi General HospitalDepartment of Surgery, Hiroshima Citizens HospitalDepartment of Surgery, Onomichi General HospitalDepartment of Surgery, Onomichi General HospitalDepartment of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima UniversityDepartment of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima UniversityDepartment of Surgery, Onomichi General HospitalDepartment of Surgery, Onomichi General HospitalAbstract Background Hepatectomy for resectable colorectal liver metastasis (CRLM) is recommended. However, the efficacy of upfront hepatectomy without neoadjuvant chemotherapy (NAC) is unclear due to the uncertainty of perioperative systemic chemotherapy. Moreover, it is crucial to predict the prognosis when considering perioperative chemotherapy. This study evaluated the impact of neoadjuvant chemotherapy on the prognosis of patients with resectable CRLM and assessed the usefulness of Beppu’s nomogram for predicting prognosis. Methods This retrospective study identified 88 consecutive inpatients who underwent primary hepatic resection for CRLM; 58 received neoadjuvant chemotherapy and 30 underwent upfront surgery. Factors associated with recurrence-free survival were identified via univariate and multivariate analysis. Furthermore, propensity score analysis using inverse probability of treatment weighting (IPTW) was performed. Results On univariate analysis, poor recurrence-free survival was associated with multiple tumors, advanced primary tumor stage, vascular invasion by the primary tumor, a Beppu’s nomogram score ≥ 6, and neoadjuvant chemotherapy. On multivariate analysis, a Beppu’s nomogram score ≥ 6 and neoadjuvant chemotherapy were independent risk factors for recurrence. Neoadjuvant chemotherapy recipients had a higher incidence of lymph node metastasis and vascular invasion than non-recipients. Propensity score analysis revealed no significant difference in the recurrence-free survival rate between these groups. Conclusions Our results show that upfront hepatectomy without neoadjuvant chemotherapy can be considered for resectable CRLM treatment. Beppu’s nomogram score can be a tool for predicting the prognosis of patients with CRLM.https://doi.org/10.1186/s12957-021-02210-9Beppu’s nomogram scoreNeoadjuvant chemotherapyHepatectomy |
| spellingShingle | Kosuke Ono Tomoyuki Abe Akihiko Oshita Yusuke Sumi Takuya Yano Hiroshi Okuda Manabu Kurayoshi Tsuyoshi Kobayashi Hideki Ohdan Toshio Noriyuki Masahiro Nakahara Efficacy of upfront hepatectomy without neoadjuvant chemotherapy for resectable colorectal liver metastasis World Journal of Surgical Oncology Beppu’s nomogram score Neoadjuvant chemotherapy Hepatectomy |
| title | Efficacy of upfront hepatectomy without neoadjuvant chemotherapy for resectable colorectal liver metastasis |
| title_full | Efficacy of upfront hepatectomy without neoadjuvant chemotherapy for resectable colorectal liver metastasis |
| title_fullStr | Efficacy of upfront hepatectomy without neoadjuvant chemotherapy for resectable colorectal liver metastasis |
| title_full_unstemmed | Efficacy of upfront hepatectomy without neoadjuvant chemotherapy for resectable colorectal liver metastasis |
| title_short | Efficacy of upfront hepatectomy without neoadjuvant chemotherapy for resectable colorectal liver metastasis |
| title_sort | efficacy of upfront hepatectomy without neoadjuvant chemotherapy for resectable colorectal liver metastasis |
| topic | Beppu’s nomogram score Neoadjuvant chemotherapy Hepatectomy |
| url | https://doi.org/10.1186/s12957-021-02210-9 |
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