Significance of poor performance status after resection of colorectal liver metastases
Abstract Background Performance status (PS) is known as one of the strongest prognostic factors for survival in metastatic colorectal cancer patients. The aim of the present study was to analyze factors associated with poor PS assessed after resection for colorectal liver metastases and the impact o...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-01-01
|
| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12957-017-1306-1 |
| _version_ | 1818899341917552640 |
|---|---|
| author | Peter Strandberg Holka Sam Eriksson Jakob Eberhard Magnus Bergenfeldt Gert Lindell Christian Sturesson |
| author_facet | Peter Strandberg Holka Sam Eriksson Jakob Eberhard Magnus Bergenfeldt Gert Lindell Christian Sturesson |
| author_sort | Peter Strandberg Holka |
| collection | DOAJ |
| description | Abstract Background Performance status (PS) is known as one of the strongest prognostic factors for survival in metastatic colorectal cancer patients. The aim of the present study was to analyze factors associated with poor PS assessed after resection for colorectal liver metastases and the impact on survival. Methods All patients undergoing curative resection for colorectal liver metastases between 2010 and 2015 in a single center were reviewed retrospectively. Results A total of 284 patients were included, out of whom 74 patients (26%) presented with a postoperative PS WHO > 2 precluding administration of adjuvant chemotherapy. These patients had a shorter recurrence-free survival (P = 0.002) and shorter overall survival (P < 0.001). Multivariable analysis showed that patients with PS > 2 after surgery had higher preoperative ASA score, had a higher frequency of major complications after surgery, and had more frequently synchronous liver and lung metastases. PS was found to be the strongest independent factor predicting survival (hazard ratio 0.45). When patients with postoperative PS > 2 developed recurrent disease (54 of 74), 43 (80%) received tumor specific treatment. Conclusions Patients with postoperative PS > 2 who did not receive adjuvant chemotherapy had decreased recurrence-free and overall survival after liver resection for colorectal liver metastases. After recurrence, a large majority of these patients had had improvement in PS allowing for administration of tumor specific treatment. |
| first_indexed | 2024-12-19T19:46:26Z |
| format | Article |
| id | doaj.art-7c19046d2156470dafd815205b998a85 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-12-19T19:46:26Z |
| publishDate | 2018-01-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-7c19046d2156470dafd815205b998a852022-12-21T20:08:06ZengBMCWorld Journal of Surgical Oncology1477-78192018-01-011611610.1186/s12957-017-1306-1Significance of poor performance status after resection of colorectal liver metastasesPeter Strandberg Holka0Sam Eriksson1Jakob Eberhard2Magnus Bergenfeldt3Gert Lindell4Christian Sturesson5Department of Clinical Sciences Lund, Surgery, Skane University Hospital, Lund UniversityDepartment of Clinical Sciences Lund, Surgery, Skane University Hospital, Lund UniversityDepartment of Clinical Sciences Lund, Oncology, Skane University Hospital, Lund UniversityDepartment of Clinical Sciences Lund, Surgery, Skane University Hospital, Lund UniversityDepartment of Clinical Sciences Lund, Surgery, Skane University Hospital, Lund UniversityDepartment of Clinical Sciences Lund, Surgery, Skane University Hospital, Lund UniversityAbstract Background Performance status (PS) is known as one of the strongest prognostic factors for survival in metastatic colorectal cancer patients. The aim of the present study was to analyze factors associated with poor PS assessed after resection for colorectal liver metastases and the impact on survival. Methods All patients undergoing curative resection for colorectal liver metastases between 2010 and 2015 in a single center were reviewed retrospectively. Results A total of 284 patients were included, out of whom 74 patients (26%) presented with a postoperative PS WHO > 2 precluding administration of adjuvant chemotherapy. These patients had a shorter recurrence-free survival (P = 0.002) and shorter overall survival (P < 0.001). Multivariable analysis showed that patients with PS > 2 after surgery had higher preoperative ASA score, had a higher frequency of major complications after surgery, and had more frequently synchronous liver and lung metastases. PS was found to be the strongest independent factor predicting survival (hazard ratio 0.45). When patients with postoperative PS > 2 developed recurrent disease (54 of 74), 43 (80%) received tumor specific treatment. Conclusions Patients with postoperative PS > 2 who did not receive adjuvant chemotherapy had decreased recurrence-free and overall survival after liver resection for colorectal liver metastases. After recurrence, a large majority of these patients had had improvement in PS allowing for administration of tumor specific treatment.http://link.springer.com/article/10.1186/s12957-017-1306-1Colorectal neoplasmsHepatectomy |
| spellingShingle | Peter Strandberg Holka Sam Eriksson Jakob Eberhard Magnus Bergenfeldt Gert Lindell Christian Sturesson Significance of poor performance status after resection of colorectal liver metastases World Journal of Surgical Oncology Colorectal neoplasms Hepatectomy |
| title | Significance of poor performance status after resection of colorectal liver metastases |
| title_full | Significance of poor performance status after resection of colorectal liver metastases |
| title_fullStr | Significance of poor performance status after resection of colorectal liver metastases |
| title_full_unstemmed | Significance of poor performance status after resection of colorectal liver metastases |
| title_short | Significance of poor performance status after resection of colorectal liver metastases |
| title_sort | significance of poor performance status after resection of colorectal liver metastases |
| topic | Colorectal neoplasms Hepatectomy |
| url | http://link.springer.com/article/10.1186/s12957-017-1306-1 |
| work_keys_str_mv | AT peterstrandbergholka significanceofpoorperformancestatusafterresectionofcolorectallivermetastases AT sameriksson significanceofpoorperformancestatusafterresectionofcolorectallivermetastases AT jakobeberhard significanceofpoorperformancestatusafterresectionofcolorectallivermetastases AT magnusbergenfeldt significanceofpoorperformancestatusafterresectionofcolorectallivermetastases AT gertlindell significanceofpoorperformancestatusafterresectionofcolorectallivermetastases AT christiansturesson significanceofpoorperformancestatusafterresectionofcolorectallivermetastases |