Annals of Coloproctology

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Malignant disease,Rectal cancer,Prognosis and adjuvant therapy,Colorectal cancer

Clinical Outcomes of Neoadjuvant Chemotherapy in Colorectal Cancer Patients With Synchronous Resectable Liver Metastasis: A Propensity Score Matching Analysis: Sung Hae Park, Jung Kyong Shin, Woo Yong Lee, Seong Hyeon Yun, Yong Beom Cho, Jung Wook Huh, Yoon Ah Park, Jin Seok Heo, Gyu Seong Choi, Seung Tae Kim, Young Suk Park, Hee Cheol Kim; Ann Coloproctol. 2021;37(4):244-252. Published online June 29, 2021; DOI: https://doi.org/10.3393/ac.2020.00710.0101

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Purpose
The survival benefit of neoadjuvant chemotherapy (NAC) prior to surgical resection in colorectal cancer with liver metastases (CRCLM) patients remains controversial. The aim of this study was to compare overall outcome of CRCLM patients who underwent NAC followed by surgical resection versus surgical treatment first.
Methods
We retrospectively analyzed 429 patients with stage IV colorectal cancer with synchronous liver metastases who underwent simultaneous liver resection between January 2008 and December 2016. Using propensity score matching, overall outcome between 60 patients who underwent NAC before surgical treatment and 60 patients who underwent surgical treatment first was compared.
Results
Before propensity score matching, metastatic cancer tended to involve a larger number of liver segments and the primary tumor size was bigger in the NAC group than in the primary resection group, so that a larger percentage of patients in the NAC group underwent major hepatectomy (P<0.001). After propensity score matching, demographic features and pathologic outcomes showed no significant differences between the 2 groups. In addition, there was no significant difference in short-term recovery outcomes such as postoperative morbidity (P=0.603) and oncologic outcome, including 3-year overall survival rate (P=0.285) and disease-free survival rate (P=0.730), between the 2 groups.
Conclusion
NAC prior to surgical treatment in CRCLM is considered a safe treatment that does not increase postoperative morbidity, and its impact on oncologic outcome was not inferior.

Citations

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Colon cancer: the 2023 Korean clinical practice guidelines for diagnosis and treatment
Hyo Seon Ryu, Hyun Jung Kim, Woong Bae Ji, Byung Chang Kim, Ji Hun Kim, Sung Kyung Moon, Sung Il Kang, Han Deok Kwak, Eun Sun Kim, Chang Hyun Kim, Tae Hyung Kim, Gyoung Tae Noh, Byung-Soo Park, Hyeung-Min Park, Jeong Mo Bae, Jung Hoon Bae, Ni Eun Seo, Cha
Annals of Coloproctology.2024; 40(2): 89. CrossRef
Survival of patients with colorectal liver metastases treated with and without preoperative chemotherapy: Nationwide propensity score-matched study
Michelle.R. de Graaff, Joost M. Klaase, Ronald M. van Dam, Koert F.D. Kuhlmann, Geert Kazemier, Rutger-Jan Swijnenburg, Arthur K.E. Elfrink, Cees Verhoef, J.Sven Mieog, Peter B. van den Boezem, Paul Gobardhan, Arjen M. Rijken, Daan J. Lips, Wouter G.K. Le
European Journal of Surgical Oncology.2023; 49(9): 106932. CrossRef
Laparoscopic right hemicolectomy with aortocaval lymphadenectomy, and pelvic peritoneum partial resection for ascending colon cancer
Hannah Kim, An Na Seo, Soo Yeun Park
Annals of Coloproctology.2023; 39(3): 283. CrossRef
Fluorescence-guided colorectal surgery: applications, clinical results, and protocols
Jin-Min Jung, In Ja Park, Eun Jung Park, Gyung Mo Son
Annals of Surgical Treatment and Research.2023; 105(5): 252. CrossRef
Recurrence Patterns and Risk Factors after Curative Resection for Colorectal Cancer: Insights for Postoperative Surveillance Strategies
Hyo Seon Ryu, Jin Kim, Ye Ryung Park, Eun Hae Cho, Jeong Min Choo, Ji-Seon Kim, Se-Jin Baek, Jung-Myun Kwak
Cancers.2023; 15(24): 5791. CrossRef
Surgical safety in the COVID-19 era: present and future considerations
Young Il Kim, In Ja Park
Annals of Surgical Treatment and Research.2022; 102(6): 295. CrossRef
Oncological outcomes of neoadjuvant chemotherapy in patients with resectable synchronous colorectal liver metastasis: A result from a propensity score matching study
Yu-Juan Jiang, Si-Cheng Zhou, Jing-Hua Chen, Jian-Wei Liang
Frontiers in Oncology.2022;[Epub] CrossRef
Molecular analyses of peritoneal metastasis from colorectal cancer
Chang Hyun Kim
Journal of the Korean Medical Association.2022; 65(9): 586. CrossRef
Recent Advance in the Surgical Treatment of Metastatic Colorectal Cancer-An English Version
Eun Jung Park, Seung Hyuk Baik
Journal of the Anus, Rectum and Colon.2022; 6(4): 213. CrossRef
Update on Diagnosis and Treatment of Colorectal Cancer
Chan Wook Kim
The Ewha Medical Journal.2022;[Epub] CrossRef
Direction of diagnosis and treatment improvement in colorectal cancer
In Ja Park
Journal of the Korean Medical Association.2022; 65(9): 540. CrossRef
Molecular Analyses in Peritoneal Metastasis from Colorectal Cancer: A Review-An English Version
Chang Hyun Kim
Journal of the Anus, Rectum and Colon.2022; 6(4): 197. CrossRef
Surgical treatment for metastatic colorectal cancer
Eun Jung Park, Seung Hyuk Baik
Journal of the Korean Medical Association.2022; 65(9): 568. CrossRef
Applications of propensity score matching: a case series of articles published in Annals of Coloproctology
Hwa Jung Kim
Annals of Coloproctology.2022; 38(6): 398. CrossRef

A Comparative Study of Operated and Non-operated Groups in Patients with Hepatic Metastasis from Colorectal Cancer.: Yun, Sang Chul , Kim, Hyung Chul , Chu, Chong Woo , Shin, Eung Jin , Baek, Moo Jun , Cho, Gyu Seok , Choi, Nam Kyu , Jung, Jun Chul , Song, Ok Pyung , Kim, Hyun Jung , Kim, Chan Gyoo , Lee, Joon Hyoek , Park, Seong Jin , Cho, Jun Hee , Lee, Hae Kyung , Kim, Hee Kyung , Koh, Eun Suk; J Korean Soc Coloproctol. 2007;23(6):477-482.; DOI: https://doi.org/10.3393/jksc.2007.23.6.477

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Abstract PDF: PURPOSE
The prognosis for patients with liver metastases (LM) from colorectal cancer is significantly influenced by the clinician's decision. Recently, there have been remarkable advances in treatment of LM, so there can be some changes in therapeutic modalities. We performed a comparative study between operated and non-operated groups of patients with LM to analyze the clinical outcome.
METHODS
From Feb. 2001 to Feb. 2006, 27 patients with LM underwent a hepatectomy, and 113 patients received non-surgical therapy. thirteen hepatectomized cases among the 27 patients had multiple LM. The outcomes of those 13 patients (Group A) were retrospectively compared to those of the non-operated group (Group B, n=21), which had had potentially resectable LM at the initial diagnosis or after chemotherapy, but didn't undergo hepatic resection.
RESULTS
After a median follow-up duration of 31.3 months, the estimated 3-years overall survival (OS) rates were 76.9% and 14.3% in group A and B, respectively (P=0.0001). In the stepwise Cox multivariate regression analysis, factors such as the absence of hepatic resection and a greater diameter of the liver mass independently influenced the poor survival (P=0.005 and P=0.012 respectively). Additionally, two radiologists evaluated the intraoperative ultrasonographic (IOUS) results. IOUS detected new metastatic lesions in 4/13 (30%) patients. There were sub-centimeter metastatic lesions (5~7 mm) and had not been detected in SPIO-enhanced MRI.
CONCLUSIONS
Our results compared to palliative chemotherapy suggest that aggressive surgical resection should be performed to increase the survival rate in patients with LM. Additionally, the treatment plan for LM patients should be discussed with the gastroenterololgist, the radiologist, the oncologist, and the surgeon.

Clinicopathologic Features of Colorectal Cancer with Liver Metastases.: Choi, Sun Keun , Jeon, Yong Sun , Bae, Sun Young , Kwak, Min Keun , Hur, Yoon Seok , Lee, Keon Young , Kim, Sei Joong , Cho, Young Up , Ahn, Seung Ik , Hong, Kee Chun , Shin, Seok Hwan , Kim, Kyung Rae , Woo, Ze Hong; J Korean Soc Coloproctol. 2004;20(4):211-217.

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Abstract PDF: PURPOSE
The aim of this study was to clarify the clinicopathologic features in colorectal cancer with liver metastases and to evaluate their clinical significance.
METHODS
From August 1996 to April 2002, 545 patients, who underwent radical surgery for primary colorectal cancers, were analyzed retrospectively.
RESULTS
Colorectal cancers with and without synchronous liver metastases at the time of the surgery were 36 and 509 cases, respectively. Of the 509 cases without metastases, 34 cases had metachronous liver metastases by April 2002, but the others did not. Serosal, vascular, perineural, and lymph node invasions, as well as increased preoperative CEA levels, were more frequently observed in those with synchronous liver metastases than it was in those without metastases (P<0.05). According to multivariate analyses, lymph node invasion was statistically significant as an independent variable in those with synchronous metastases (P=0.009). Serosal, vascular, and lymph node invasions, increased preoperative CEA levels, DNA ploidy, and positive lateral resection margins were more frequently observed in those with metachronous liver metastases than it was in those without metastases (P<0.05). According to multivariate analyses, vascular invasion was statistically significant in those with metachronous metastases (P=0.015).
CONCLUSIONS
Lymph node and vascular invasions appear to be significant determinants for synchronous and metachronous liver metastases in colorectal cancers. Therefore, close observation and careful postoperative follow-up is needed for such patients.

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