PMID- 29615295
OWN - NLM
STAT- MEDLINE
DCOM- 20180709
LR  - 20180709
IS  - 1532-2157 (Electronic)
IS  - 0748-7983 (Linking)
VI  - 44
IP  - 7
DP  - 2018 Jul
TI  - Radiologic and pathologic response to neoadjuvant chemotherapy predicts survival 
      in patients undergoing the liver-first approach for synchronous colorectal liver 
      metastases.
PG  - 1069-1077
LID - S0748-7983(18)30953-3 [pii]
LID - 10.1016/j.ejso.2018.03.008 [doi]
AB  - PURPOSE: To investigate the short- and long-term outcomes of liver first approach
      (LFA) in patients with synchronous colorectal liver metastases (CRLM), evaluating
      the predictive factors of survival. METHODS: Sixty-two out of 301 patients
      presenting with synchronous CRLM underwent LFA between 2007 and 2016. All
      patients underwent neoadjuvant chemotherapy. After neoadjuvant treatment patients
      were re-evaluated according to the Response Evaluation Criteria in Solid Tumors
      (RECIST). Liver resection was scheduled after 4-6 weeks. Changes in non-tumoral
      parenchyma and the tumor response according to the Tumor Regression Grade score
      (TRG) were assessed on surgical specimens. Primary tumor resection was scheduled 
      4-8 weeks following hepatectomy. RESULTS: Five patients out of 62 (8.1%) showed
      "Progressive Disease" at re-evaluation after neoadjuvant chemotherapy, 22 (35.5%)
      showed "Stable Disease" and 35 (56.5%) "Partial Response"; of these latter, 29
      (82%) showed histopathologic downstaging. The 5-year survival (OS) rate was 55%, 
      while the 5-year disease-free survival (DFS) rate was 16%. RECIST criteria,
      T-stage, N-stage and TRG were independently associated with OS. Bilobar
      presentation of disease, RECIST criteria, R1 margin and TRG were independently
      associated with DFS. Patients with response to neoadjuvant chemotherapy had
      better survival than those with stable or progressive disease (radiological
      response 5-y OS: 65% vs. 50%; 5-y DFS: 20% vs. 10%; pathological response 5-y OS:
      75% vs. 56%; 5-y DFS: 45% vs. 11%). CONCLUSIONS: LFA is an oncologically safe
      strategy. Selection is a critical point, and the best results in terms of OS and 
      DFS are observed in patients having radiological and pathological response to
      neoadjuvant chemotherapy.
CI  - Copyright (c) 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and
      the European Society of Surgical Oncology. All rights reserved.
FAU - Berardi, Giammauro
AU  - Berardi G
AD  - Dept. of General Hepatobiliary and Liver Transplantation Surgery, Ghent
      University Hospital and Medical School, C. Heymanslaan 10, Ghent 9000, Belgium.
FAU - De Man, Marc
AU  - De Man M
AD  - Dept. of Oncology, Ghent University Hospital and Medical School, Ghent, Belgium.
FAU - Laurent, Stephanie
AU  - Laurent S
AD  - Dept. of Oncology, Ghent University Hospital and Medical School, Ghent, Belgium.
FAU - Smeets, Peter
AU  - Smeets P
AD  - Dept. of Radiology, Ghent University Hospital and Medical School, Ghent, Belgium.
FAU - Tomassini, Federico
AU  - Tomassini F
AD  - Dept. of General Hepatobiliary and Liver Transplantation Surgery, Ghent
      University Hospital and Medical School, C. Heymanslaan 10, Ghent 9000, Belgium.
FAU - Ariotti, Riccardo
AU  - Ariotti R
AD  - Dept. of General Hepatobiliary and Liver Transplantation Surgery, Ghent
      University Hospital and Medical School, C. Heymanslaan 10, Ghent 9000, Belgium.
FAU - Hoorens, Anne
AU  - Hoorens A
AD  - Dept. of Pathology, Ghent University Hospital and Medical School, Ghent, Belgium.
FAU - van Dorpe, Jo
AU  - van Dorpe J
AD  - Dept. of Pathology, Ghent University Hospital and Medical School, Ghent, Belgium.
FAU - Varin, Oswald
AU  - Varin O
AD  - Dept. of Gastroenterology, Ghent University Hospital and Medical School, Ghent,
      Belgium.
FAU - Geboes, Karen
AU  - Geboes K
AD  - Dept. of Oncology, Ghent University Hospital and Medical School, Ghent, Belgium.
FAU - Troisi, Roberto I
AU  - Troisi RI
AD  - Dept. of General Hepatobiliary and Liver Transplantation Surgery, Ghent
      University Hospital and Medical School, C. Heymanslaan 10, Ghent 9000, Belgium;
      Department of Clinical Medicine and Surgery, Federico II University, Naples,
      Italy. Electronic address: roberto.troisi@ugent.be.
LA  - eng
PT  - Journal Article
DEP - 20180321
PL  - England
TA  - Eur J Surg Oncol
JT  - European journal of surgical oncology : the journal of the European Society of
      Surgical Oncology and the British Association of Surgical Oncology
JID - 8504356
RN  - 0 (Antineoplastic Agents, Immunological)
RN  - 0 (Organoplatinum Compounds)
RN  - 2S9ZZM9Q9V (Bevacizumab)
RN  - PQX0D8J21J (Cetuximab)
RN  - Q573I9DVLP (Leucovorin)
RN  - U3P01618RT (Fluorouracil)
RN  - XT3Z54Z28A (Camptothecin)
RN  - Folfox protocol
RN  - IFL protocol
SB  - IM
MH  - Aged
MH  - Antineoplastic Agents, Immunological/*therapeutic use
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Bevacizumab/*therapeutic use
MH  - Camptothecin/*analogs & derivatives/therapeutic use
MH  - Cetuximab/*therapeutic use
MH  - Cohort Studies
MH  - Colectomy
MH  - Colorectal Neoplasms/mortality/*pathology/surgery
MH  - Disease-Free Survival
MH  - Female
MH  - Fluorouracil/therapeutic use
MH  - Hepatectomy
MH  - Humans
MH  - Leucovorin/therapeutic use
MH  - Liver Neoplasms/*drug therapy/secondary
MH  - Male
MH  - Margins of Excision
MH  - Metastasectomy
MH  - Middle Aged
MH  - Neoadjuvant Therapy/*methods
MH  - Organoplatinum Compounds/therapeutic use
MH  - Radiotherapy/methods
MH  - Response Evaluation Criteria in Solid Tumors
MH  - Survival Rate
MH  - Treatment Outcome
OTO - NOTNLM
OT  - *Liver first
OT  - *Oncological outcomes
OT  - *Radiological response
OT  - *Tumor regression grade score (TRG)
EDAT- 2018/04/05 06:00
MHDA- 2018/07/10 06:00
CRDT- 2018/04/05 06:00
PHST- 2017/12/14 00:00 [received]
PHST- 2018/02/26 00:00 [revised]
PHST- 2018/03/09 00:00 [accepted]
PHST- 2018/04/05 06:00 [pubmed]
PHST- 2018/07/10 06:00 [medline]
PHST- 2018/04/05 06:00 [entrez]
AID - S0748-7983(18)30953-3 [pii]
AID - 10.1016/j.ejso.2018.03.008 [doi]
PST - ppublish
SO  - Eur J Surg Oncol. 2018 Jul;44(7):1069-1077. doi: 10.1016/j.ejso.2018.03.008. Epub
      2018 Mar 21.