Abstract
Purpose
To explore the optimal timing of locoregional therapy in patients with colorectal cancer (CRC) recurrence after radical resection and initially unresectable liver metastases but no other metastases and whether maintenance therapy should be performed after achieving no evidence of disease (NED).
Methods
This study was jointly carried out in six medical institutions in China to collect the clinical data of patients with primary CRC from January 2015 to December 2021. Research participants were identified according to the inclusion criteria of this study for statistical analysis of the clinical characteristics and recurrence time.
Results
625 patients CRC with metachronous initially unresectable liver metastases but no other metastases were enrolled. Multivariate analysis showed that the number of metastases in the liver and the time from the start of first-line chemotherapy to locoregional therapy significantly affected the progression-free survival (PFS, P < 0.05) following the first-line treatment, and continued maintenance therapy reduced the risk of tumor progression in the patients (P < 0.05). Furthermore, stratified analysis showed that the median PFS of patients with 3–5 metastases in the liver was maximized when the time from the start of first-line chemotherapy to locoregional therapy was 3–4 months. Patients with > 6 metastases in the liver should extend the duration between the start of first-line chemotherapy and locoregional therapy to more than four months. Similarly, with the significant increase in the number of metastases in the liver, subsequent maintenance therapy significantly extended the PFS of the patients.
Conclusions
The overall therapeutic plan in patients with CRC recurrence after radical resection and initially unresectable liver metastases but no other metastases should consider the individual patients' situations, especially the number of metastases in the liver at initial recurrence.
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Data availability
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
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Funding
This work was supported by Beijing Xisike Clinical Oncology Research Foundation (No: Y-HR2018-321).
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LB took part in conception and design. YJQ, YDJ, YY, FXS, and PG took part in collection and assembly of clinical data. SSY and TTZ participated in data analysis and involved in manuscript writing. All authors read and approved the final manuscript.
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The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as potential conflicts of interest.
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This retrospective study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of The People's Liberation Army General Hospital (2/23/2017/No.S2017-009-01).
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Ye, S., Bai, L., Qi, Y. et al. Retrospective analysis of colorectal cancer patients with metachronous initially unresectable liver metastases (and no other) achieving no evidence of disease after first-line comprehensive therapy: a multicenter real-world study. J Cancer Res Clin Oncol 149, 8403–8413 (2023). https://doi.org/10.1007/s00432-023-04768-1
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DOI: https://doi.org/10.1007/s00432-023-04768-1