Hepatic and Extrahepatic Colorectal Metastases Have Discordant Responses to Systemic Therapy. Pathology Data from Patients Undergoing Simultaneous Resection of Multiple Tumor Sites
Background: Systemic therapy is the standard treatment for patients with hepatic and extrahepatic colorectal metastases. It is assumed to have the same effectiveness on all disease foci, independent of the involved organ. The present study aims to compare the response rates of hepatic and extrahepat...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-01-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/3/464 |
| _version_ | 1797407317813100544 |
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| author | Luca Vigano Pio Corleone Shadya Sara Darwish Nicolò Turri Simone Famularo Lorenzo Viggiani Lorenza Rimassa Daniele Del Fabbro Luca Di Tommaso Guido Torzilli |
| author_facet | Luca Vigano Pio Corleone Shadya Sara Darwish Nicolò Turri Simone Famularo Lorenzo Viggiani Lorenza Rimassa Daniele Del Fabbro Luca Di Tommaso Guido Torzilli |
| author_sort | Luca Vigano |
| collection | DOAJ |
| description | Background: Systemic therapy is the standard treatment for patients with hepatic and extrahepatic colorectal metastases. It is assumed to have the same effectiveness on all disease foci, independent of the involved organ. The present study aims to compare the response rates of hepatic and extrahepatic metastases to systemic therapy. Methods: All consecutive patients undergoing simultaneous resection of hepatic and extrahepatic metastases from colorectal cancer after oxaliplatin- and/or irinotecan-based preoperative chemotherapy were analyzed. All specimens were reviewed. Pathological response to chemotherapy was classified according to tumor regression grade (TRG). Results: We analyzed 45 patients undergoing resection of 134 hepatic and 72 extrahepatic metastases. Lung and lymph node metastases had lower response rates to chemotherapy than liver metastases (TRG 4–5 95% and 100% vs. 67%, <i>p</i> = 0.008, and <i>p</i> = 0.006). Peritoneal metastases had a higher pathological response rate than liver metastases (TRG 1–3 66% vs. 33%, <i>p</i> < 0.001) and non-hepatic non-peritoneal metastases (3%, <i>p</i> < 0.001). Metastases site was an independent predictor of pathological response to systemic therapy. Conclusions: Response to chemotherapy of distant metastases from colorectal cancer varies in different organs. Systemic treatment is highly effective for peritoneal metastases, more so than liver metastases, while it has a very poor impact on lung and lymph node metastases. |
| first_indexed | 2024-03-09T03:39:37Z |
| format | Article |
| id | doaj.art-95ec52933f324142a94b0a53c5d0b5fc |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T03:39:37Z |
| publishDate | 2021-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-95ec52933f324142a94b0a53c5d0b5fc2023-12-03T14:43:47ZengMDPI AGCancers2072-66942021-01-0113346410.3390/cancers13030464Hepatic and Extrahepatic Colorectal Metastases Have Discordant Responses to Systemic Therapy. Pathology Data from Patients Undergoing Simultaneous Resection of Multiple Tumor SitesLuca Vigano0Pio Corleone1Shadya Sara Darwish2Nicolò Turri3Simone Famularo4Lorenzo Viggiani5Lorenza Rimassa6Daniele Del Fabbro7Luca Di Tommaso8Guido Torzilli9Division of Hepatobiliary and General Surgery—Department of Surgery, Humanitas Clinical and Research Center—IRCCS, 20089 Rozzano, Milan, ItalyDivision of Hepatobiliary and General Surgery—Department of Surgery, Humanitas Clinical and Research Center—IRCCS, 20089 Rozzano, Milan, ItalyDivision of Hepatobiliary and General Surgery—Department of Surgery, Humanitas Clinical and Research Center—IRCCS, 20089 Rozzano, Milan, ItalyDepartment of Biomedical Science, Humanitas University, 20090 Pieve Emanuele, Milan, ItalyDivision of Hepatobiliary and General Surgery—Department of Surgery, Humanitas Clinical and Research Center—IRCCS, 20089 Rozzano, Milan, ItalyDepartment of Biomedical Science, Humanitas University, 20090 Pieve Emanuele, Milan, ItalyDepartment of Biomedical Science, Humanitas University, 20090 Pieve Emanuele, Milan, ItalyDivision of Hepatobiliary and General Surgery—Department of Surgery, Humanitas Clinical and Research Center—IRCCS, 20089 Rozzano, Milan, ItalyDepartment of Biomedical Science, Humanitas University, 20090 Pieve Emanuele, Milan, ItalyDivision of Hepatobiliary and General Surgery—Department of Surgery, Humanitas Clinical and Research Center—IRCCS, 20089 Rozzano, Milan, ItalyBackground: Systemic therapy is the standard treatment for patients with hepatic and extrahepatic colorectal metastases. It is assumed to have the same effectiveness on all disease foci, independent of the involved organ. The present study aims to compare the response rates of hepatic and extrahepatic metastases to systemic therapy. Methods: All consecutive patients undergoing simultaneous resection of hepatic and extrahepatic metastases from colorectal cancer after oxaliplatin- and/or irinotecan-based preoperative chemotherapy were analyzed. All specimens were reviewed. Pathological response to chemotherapy was classified according to tumor regression grade (TRG). Results: We analyzed 45 patients undergoing resection of 134 hepatic and 72 extrahepatic metastases. Lung and lymph node metastases had lower response rates to chemotherapy than liver metastases (TRG 4–5 95% and 100% vs. 67%, <i>p</i> = 0.008, and <i>p</i> = 0.006). Peritoneal metastases had a higher pathological response rate than liver metastases (TRG 1–3 66% vs. 33%, <i>p</i> < 0.001) and non-hepatic non-peritoneal metastases (3%, <i>p</i> < 0.001). Metastases site was an independent predictor of pathological response to systemic therapy. Conclusions: Response to chemotherapy of distant metastases from colorectal cancer varies in different organs. Systemic treatment is highly effective for peritoneal metastases, more so than liver metastases, while it has a very poor impact on lung and lymph node metastases.https://www.mdpi.com/2072-6694/13/3/464colorectal hepatic and extrahepatic metastasessystemic therapychemotherapytargeted therapieslung metastasesperitoneal metastases |
| spellingShingle | Luca Vigano Pio Corleone Shadya Sara Darwish Nicolò Turri Simone Famularo Lorenzo Viggiani Lorenza Rimassa Daniele Del Fabbro Luca Di Tommaso Guido Torzilli Hepatic and Extrahepatic Colorectal Metastases Have Discordant Responses to Systemic Therapy. Pathology Data from Patients Undergoing Simultaneous Resection of Multiple Tumor Sites Cancers colorectal hepatic and extrahepatic metastases systemic therapy chemotherapy targeted therapies lung metastases peritoneal metastases |
| title | Hepatic and Extrahepatic Colorectal Metastases Have Discordant Responses to Systemic Therapy. Pathology Data from Patients Undergoing Simultaneous Resection of Multiple Tumor Sites |
| title_full | Hepatic and Extrahepatic Colorectal Metastases Have Discordant Responses to Systemic Therapy. Pathology Data from Patients Undergoing Simultaneous Resection of Multiple Tumor Sites |
| title_fullStr | Hepatic and Extrahepatic Colorectal Metastases Have Discordant Responses to Systemic Therapy. Pathology Data from Patients Undergoing Simultaneous Resection of Multiple Tumor Sites |
| title_full_unstemmed | Hepatic and Extrahepatic Colorectal Metastases Have Discordant Responses to Systemic Therapy. Pathology Data from Patients Undergoing Simultaneous Resection of Multiple Tumor Sites |
| title_short | Hepatic and Extrahepatic Colorectal Metastases Have Discordant Responses to Systemic Therapy. Pathology Data from Patients Undergoing Simultaneous Resection of Multiple Tumor Sites |
| title_sort | hepatic and extrahepatic colorectal metastases have discordant responses to systemic therapy pathology data from patients undergoing simultaneous resection of multiple tumor sites |
| topic | colorectal hepatic and extrahepatic metastases systemic therapy chemotherapy targeted therapies lung metastases peritoneal metastases |
| url | https://www.mdpi.com/2072-6694/13/3/464 |
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